Online Reviews of Hemodialysis Centers Correlate With Medicare and Medicaid Survey Measures of Patient Experience

Abstract

Background and Objectives: Patient experience in outpatient hemodialysis has been shown to be significantly correlated with health outcomes. The current gold standard for assessing patient experience in outpatient hemodialysis is the In-Center Hemodialysis Consumer Assessment of Healthcare Providers and Systems (ICH-CAHPS). Online reviews of outpatient hemodialysis centers could potentially serve as an additional source of information regarding patient experience, but they have not been well validated. This study aims to determine whether overall scores and subscores from patient-authored online reviews of outpatient dialysis centers are correlated with current gold standard survey-based measures of patient experience in outpatient hemodialysis. Methods: All reviews of hemodialysis centers posted to the online review site CiteHealth.com between March 2008 and October 2019 were collected (1081 reviews of 762 centers). Publicly-available ICH-CAHPS survey summary data and End Stage Renal Disease Quality Incentive Program (ESRD QIP) summary data from May 2016 to October 2019 were obtained from the Dialysis Facility Compare website. Spearman correlation coefficients were calculated between facilities mean online review overall scores and subscores within a given year and their ICH-CAHPS ratings from the same year. Statistical significance was assessed with a 2-tailed permutation test. A Bonferroni correction for multiple hypothesis testing was applied. Results: The mean “Overall” score from CiteHealth.com had a significant positive correlation with the “Center Care Quality,” “Staff,” and “Facility” scores from ICH-CAHPS surveys. No significant correlation could be found between the mean “Overall” CiteHealth.com score and any other ICH-CAHPS patient satisfaction metric. There was a significant positive correlation between the mean CiteHealth.com “Center” score and the ICH-CAHPS “Center Care Quality” score, the mean CiteHealth.com “Facility” score and the ICH-CAHPS “Facility” score, and the mean CiteHealth.com “Staff” score and the ICH-CAHPS “Staff” score. No significant correlation was found between the mean CiteHealth.com “Nephrologist” score and the ICH-CAHPS “Nephrologist” score. No significant correlation was found between online review scores and ESRD QIP health outcome measures. Conclusion: Certain components of online reviews are significantly correlated with ICH-CAHPS measures of patient experience. Additionally, online reviews come with narrative comments that can offer specific insights into positive and negative aspects of patient care that cannot always be elucidated by numeric survey questions. Online reviews may have utility as an adjunctive source of information to patient experience surveys such as the ICH-CAHPS.