For example, 65% of surveyed patients in 2020 used web-based reviews to evaluate doctors, and Google was the most visited review site. Understanding the association between crowdsourced opinions and expert hospital quality ratings is important because web-based ratings appear to have substantial influence on patients’ health care choices. In this analysis, we explored the association between a popular crowdsourced, web-based hospital quality rating (Google star) and expert rating of hospital quality (HCSR) published by the Centers for Medicare & Medicaid Services (CMS). Especially for complex services such as medical treatment, consumers may not have the expertise to evaluate the quality of care even after the completion of the consumption cycle, and crowdsourced ratings may have little or no correspondence with true quality, due to cognitive limitations and expertise gap. Although crowdsourced ratings are widely used, including in health care settings, concerns arise about crowdsourced assessments due to the following reasons: (1) nonrepresentative nature of the sampling process, (2) inadequacies in expertise required to assess the quality of the goods or services provided, (3) the limited nature of experiences, and (4) the potential for manipulation. If used effectively, crowdsourcing can gather timely feedback, improve efficiency and supervision, reduce response times for critical actions, and increase customer engagement and satisfaction.
In recent years, crowdsourced, web-based information aggregated by social media platforms, service providers, and government agencies has become a popular source for consumers, organizations, and governments. Hospitals can benefit from using crowdsourced ratings as timely and easily available indicators of their quality performance while recognizing their limitations and biases. Improvements in hospital quality metrics that require expertise to assess, such as safety of care and readmission, may not lead to improved Google star ratings. The revised CMS rating system ameliorates previous partial inconsistencies in the association between Google star ratings and quality component scores of HCSR.Ĭonclusions: Crowdsourced Google star hospital ratings are informative regarding expert CMS overall hospital quality ratings and individual quality components that are easier for patients to evaluate. Results: The Google star ratings are statistically associated with HCSR ( P<.001) after controlling for hospital-level effects however, they are not associated with clinical components of HCSR that require medical expertise for evaluation such as safety of care ( P=.30) or readmission ( P=.52). Fractional response models were used to estimate the association between Google star ratings and HCSR as well as individual components of quality (n=2619).
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We also extracted scores for the individual components of hospital quality for each of the hospitals in our sample using the code provided by Hospital Compare. The HCSR data of April 2020 (before the revision of HCSR methodology) and April 2021 (after the revision of HCSR methodology) were obtained from the CMS Hospital Compare website. Methods: We extracted Google star ratings using the Application Programming Interface in June 2020.
Objective: This study aims to assess the association between web-based, Google hospital quality ratings that reflect the opinions of the crowd and HCSR representing the wisdom of the experts, as well as the changes in these associations following the 2021 revision of the CMS rating system. It is important to analyze the degree to which web-based ratings reflect expert measures of hospital quality because easily accessible, crowdsourced hospital ratings influence consumers’ hospital choices. The Centers for Medicare & Medicaid Services (CMS) also publishes Hospital Compare Star Ratings (HCSR), a comprehensive expert rating of US hospital quality that aggregates multiple measures of quality.
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