Capital One Financial Corporation, McLean, VA, United States.
Department of Economics, Lehigh University, Bethlehem, PA, United States.
J Med Internet Res. 2021 Oct 28;23(10):e28098. doi: 10.2196/28098.
Patients may use two information sources about a health care provider's quality: online physician reviews, which are written by patients to reflect their subjective experience, and report cards, which are based on objective health outcomes.
The aim of this study was to examine the impact of online ratings on patient choice of cardiac surgeon compared to that of report cards.
We obtained ratings from a leading physician review platform, Vitals; report card scores from Pennsylvania Cardiac Surgery Reports; and information about patients' choices of surgeons from inpatient records on coronary artery bypass graft (CABG) surgeries done in Pennsylvania from 2008 to 2017. We scraped all reviews posted on Vitals for surgeons who performed CABG surgeries in Pennsylvania during our study period. We linked the average overall rating and the most recent report card score at the time of a patient's surgery to the patient's record based on the surgeon's name, focusing on fee-for-service patients to avoid impacts of insurance networks on patient choices. We used random coefficient logit models with surgeon fixed effects to examine the impact of receiving a high online rating and a high report card score on patient choice of surgeon for CABG surgeries.
We found that a high online rating had positive and significant effects on patient utility, with limited variation in preferences across individuals, while the impact of a high report card score on patient choice was trivial and insignificant. About 70.13% of patients considered no information on Vitals better than a low rating; the corresponding figure was 26.66% for report card scores. The findings were robust to alternative choice set definitions and were not explained by surgeon attrition, referral effect, or admission status. Our results also show that the interaction effect of rating information and a time trend was positive and significant for online ratings, but small and insignificant for report cards.
A patient's choice of surgeon is affected by both types of rating information; however, over the past decade, online ratings have become more influential, while the effect of report cards has remained trivial. Our findings call for information provision strategies that incorporate the advantages of both online ratings and report cards.
患者可能会使用两种信息来源来了解医疗保健提供者的质量：在线医生评价，由患者撰写，反映其主观体验；以及报告卡，基于客观的健康结果。
本研究旨在考察在线评分对比报告卡对患者选择心脏外科医生的影响。
我们从领先的医生评价平台 Vitals 获得评分；从宾夕法尼亚州心脏手术报告获得报告卡分数；并从 2008 年至 2017 年宾夕法尼亚州进行的冠状动脉旁路移植术 (CABG) 手术的住院记录中获取患者选择外科医生的信息。我们从研究期间在宾夕法尼亚州进行 CABG 手术的外科医生那里抓取了 Vitals 上发布的所有评论。我们根据外科医生的名字将患者手术时的平均整体评分和最近的报告卡评分与患者的记录联系起来，重点关注自费患者，以避免保险网络对患者选择的影响。我们使用带有外科医生固定效应的随机系数逻辑模型来检验接受高在线评分和高报告卡评分对 CABG 手术患者选择外科医生的影响。
我们发现高在线评分对患者效用有积极且显著的影响，个体之间的偏好差异有限，而报告卡评分对患者选择的影响微不足道且不显著。大约 70.13%的患者认为 Vitals 上没有信息比低评分更好；对于报告卡评分，相应的比例为 26.66%。替代选择集定义的稳健性检验和外科医生流失、转诊效应或入院状态都无法解释这一结果。我们的研究结果还表明，评分信息与时间趋势的交互效应对于在线评分是积极且显著的，而对于报告卡则很小且不显著。
患者选择外科医生会受到这两种评分信息的影响；然而，在过去十年中，在线评分的影响力越来越大，而报告卡的影响仍然微不足道。我们的研究结果呼吁采取信息提供策略，结合在线评分和报告卡的优势。
