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JAMA Published Study Finds Yelp Reviews Can Identify Racist Patient Experiences in Healthcare

Key Findings From “Evaluation of Online Consumer Reviews of Hospitals and Experiences of Racism Using Qualitative Methods

  • Consumer reviews on Yelp can help identify acts of interpersonal racism in health care, and supplement existing hospital-based reporting measures to explore concepts such as patient-to-employee racism.
  • The researchers chose to examine Yelp reviews for the study given the platform’s expansive dataset on consumer experiences, and because Yelp “screens out potentially falsified reviews to prevent skewed ratings.”

Racial disparities have long plagued healthcare, with COVID-19 being one of the most recent reminders of the disproportionate impact of implicit bias and racism for the experiences of racial and ethnic minorities. 

A recent study published in JAMA Network Open, Jason Tong and colleagues at the University of Pennsylvania found that consumer reviews can help identify alleged racist experiences in health care. With a rich dataset of more than 224 million reviews, Yelp has become a useful resource for researchers and regulators, as well as for health care professionals to better understand consumer interactions with employees and aspects of care not traditionally reported on, like staff experiences, follow-up aftercare, scheduling and more.

In the report, Tong notes that “Consumer reviews offer an opportunity to understand subjective perceptions of racism in health care in an unstructured and anonymous format.” He also points out that consumer reviews have a “unique ability to highlight novel concepts not captured in traditional performance metrics and to impact consumer hospital selection.”

To understand how consumer reviews can be used to study interpersonal racism in health care, the researchers analyzed 90,786 Yelp consumer reviews on U.S. hospitals published between January 2010-2020 to identify reviews that mention episodes of racism. Yelp reviews were examined for the study because of our efforts to combat fraudulent reviews to ensure that our content is reliable and useful. Tong said to Yelp via email,​​ “Yelp is updated frequently and actively filters falsified reviews and information that could negatively skew our analysis. That regular moderation of content makes it a trustworthy source for us to leverage in this type of research centered on patient experiences.” This is a testament to the significant measures Yelp takes to maintain the integrity and quality of the content on our platform, which is a core differentiator that sets Yelp apart from other review platforms.

Of the 90,000+ consumer reviews evaluated, the researchers identified 260 reviews specifically citing racism in 190 hospitals across 33 states, and found that the most common themes across incidents citing racism include disrespect, unprofessionalism and acts of omission. The study also found that “episodes of racism were 2.5 times more frequently associated with clinical encounters (143 of 260) compared with nonclinical environments.” In reference to his study, Tong told the Philadelphia Inquirer that Yelp is powerful because “it reduces the fear of reporting, it’s familiar, and it’s open-ended… It allows consumers to comment on what matters to them.”

Based on their findings, the authors determined that “it is feasible to identify acts of interpersonal racism in health care using qualitative methods on consumer reviews,” and that supplementing data from consumer reviews with “existing hospital-based reporting measures, such as human resources reports, may help to further explore concepts such as patient-to-employee racism,” wrote Tong and his co-authors. 

In reference to the study’s findings that the vast majority of reviews mentioning racism cite an individual offender, Tong told the Philadelphia Inquirer that “we as health-care leaders should turn to consumers more often.”

To learn more, you can read the full study: Evaluation of Online Consumer Reviews of Hospitals and Experiences of Racism Using Qualitative Methods