Department of Engineering Management and Systems Engineering, School of Engineering and Applied Science, George Washington University, Washington, DC, United States.
Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University School of Medicine and Health Sciences, Washington, DC, United States.
J Med Internet Res. 2021 Oct 8;23(10):e29406. doi: 10.2196/29406.
Providers of on-demand care, such as those in urgent care centers, may prescribe antibiotics unnecessarily because they fear receiving negative reviews on web-based platforms from unsatisfied patients-the so-called Yelp effect. This effect is hypothesized to be a significant driver of inappropriate antibiotic prescribing, which exacerbates antibiotic resistance.
In this study, we aimed to determine the frequency with which patients left negative reviews on web-based platforms after they expected to receive antibiotics in an urgent care setting but did not.
We obtained a list of 8662 urgent care facilities from the Yelp application programming interface. By using this list, we automatically collected 481,825 web-based reviews from Google Maps between January 21 and February 10, 2019. We used machine learning algorithms to summarize the contents of these reviews. Additionally, 200 randomly sampled reviews were analyzed by 4 annotators to verify the types of messages present and whether they were consistent with the Yelp effect.
We collected 481,825 reviews, of which 1696 (95% CI 1240-2152) exhibited the Yelp effect. Negative reviews primarily identified operations issues regarding wait times, rude staff, billing, and communication.
Urgent care patients rarely express expectations for antibiotics in negative web-based reviews. Thus, our findings do not support an association between a lack of antibiotic prescriptions and negative web-based reviews. Rather, patients' dissatisfaction with urgent care was most strongly linked to operations issues that were not related to the clinical management plan.
按需医疗服务提供者，如急诊中心的医生，可能会不必要地开出抗生素，因为他们担心在基于网络的平台上收到不满意患者的负面评价——所谓的 Yelp 效应。这种效应被假设是不合理使用抗生素的一个重要驱动因素，会加剧抗生素耐药性。
在这项研究中，我们旨在确定在急诊环境中患者预期接受抗生素治疗但未获得时在网络平台上留下负面评价的频率。
我们从 Yelp 应用程序接口获取了 8662 家急诊中心的列表。通过使用该列表，我们在 2019 年 1 月 21 日至 2 月 10 日期间通过 Google Maps 自动收集了 481825 条网络评价。我们使用机器学习算法来总结这些评价的内容。此外，通过 4 名注释者分析了 200 条随机抽样的评价，以验证存在的信息类型以及它们是否与 Yelp 效应一致。
我们共收集了 481825 条评价，其中 1696 条（95%CI 1240-2152）表现出了 Yelp 效应。负面评价主要针对等待时间、工作人员粗鲁、计费和沟通等运营问题。
急诊患者在负面网络评价中很少表达对抗生素的期望。因此，我们的发现并不支持缺乏抗生素处方与负面网络评价之间存在关联。相反，患者对急诊的不满主要与与临床管理计划无关的运营问题有关。
