Using Social Media to Investigate Geographic and Macro-Level Variations in LGBTQ Patient Experiences (Preprint)
BACKGROUND Discrimination in the healthcare system contributes to worse health outcomes among lesbian, gay, bisexual, transgender and queer (LGBTQ) patients. OBJECTIVE To examine disparities in patient experience among LGBTQ persons using social media data. METHODS We collected patient experience data from Twitter from February 2013 to February 2017 in the United States. We compared sentiment of patient experience tweets between Twitter users who self-identified as LGBTQ and non-LGBTQ. The effect of state-level partisan identity on patient experience sentiment and differences between LGBTQ users and non-LGBTQ users were analyzed. RESULTS We observed lower patient experience sentiment among 13,689 LGBTQ users compared to 1,362,395 non-LGBTQ users. Increasing state-level liberal political identification was associated with higher patient experience sentiment among all users but had stronger effects for LGBTQ users. CONCLUSIONS Our findings highlight that social media data can yield insights about patient experience for LGBTQ persons and suggest that state-level socio-political environment influences patient experience for this group. Efforts are needed to reduce disparities in patient care for LGBTQ persons while taking into context the effect of political climate on these inequities. CLINICALTRIAL