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What urgent care centers do better than EDs (and how hospitals can improve), according to 100,000 Yelp reviews


As urgent care centers become a popular alternative to the ED, Yelp reviews can offer insight into what EDs lack in comparison—and where they have a leg up, according to a new study published in the Annals of Emergency Medicine.

Cheat sheet: Your guide to responding to online reviews

Patients increasingly opt for urgent care

For the study, researchers from the Perelman School of Medicine at the University of Pennsylvania looked at crowdsourced reviews to better understand why patients are flocking to urgent care centers. According to Penn Medicine, visits to urgent care centers increased by more than 1,700% between 2007 and 2016.

"Today's world is very digital," said Anish Agarwal, an ED physician at Penn Medicine and a lead author of the study. "As an emergency department physician, patients often tell me that the internet is the first place they go for information about medical conditions and to research providers," he said.

The researchers analyzed more than 100,000 Yelp reviews for more than 1,500 EDs and 5,600 urgent care centers to determine what patients considered to be the pros and cons of receiving acute care in one setting versus the other.

Where urgent care centers thrive—and flounder

The reviews tended to be either very low (one-star) or very high (five stars), according to the study. The researchers found that EDs had a higher percentage of low reviews than urgent care centers. Forty-seven percent of ED reviews were one-star compared with 30% of urgent care center reviews.

When EDs received five stars, patients usually commented favorably on bedside manner, access to care on weekends and evenings, and treatment of family. Urgent care centers received high reviews for different factors, including positive recommendations from someone the patient knows or the ease of prescription refills. 

EDs received their worst reviews when patients were dissatisfied with the speed of care. Urgent care centers, on the other hand, received one-star reviews when patients had bad experiences with reception or lacked confidence in the care.

Both facility types received five-star reviews for cleanliness, pediatric care, and professionalism as well as similar one-star reviews for excessive wait times, billing, and pain after care.

How EDs can use crowd-sourced reviews to their advantage

The study authors said that the online reviews could fill knowledge gaps about patient experience for health care providers. "Understanding drivers for high and low online ratings and what patients value in their ED and urgent care center experiences offers insights for health systems and providers to improve acute care delivery," the study authors wrote.

Separately, Raina Merchant, senior author of the study and director of the Penn Medicine Center for Digital Health, said as interest in urgent care centers continues to expand, the crowdsourced reviews can provide EDs with a "rapid way of taking the pulse of how this acute care market is emerging and what consumers look for in these settings." She added, "These platforms can also help us identify new focus areas, in an effort to provide better, more efficient care to patients based on their expressed needs."

In addition, Kevin Mahoney, EVP and chief administrative officer of the University of Pennsylvania Health System, said providers shouldn't expect the positive or negative reviews to lose their value to patients anytime soon. "We are seeing more and more that patients are sharing their experiences online, and they're looking to social media platforms and online communities to help inform their decision-making," Mahoney said (Fottrell, MarketWatch, 11/12; Penn Medicine release, 11/9).

Your guide to responding to online reviews

Responding to online reviews can be tricky—use this cheat sheet to learn best practices for strategically responding in a HIPAA-compliant, patient-friendly manner.

Get the Cheat Sheet


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