Wisdom of the Experts versus Wisdom of the Crowd in Hospital Quality Ratings: Cross-Sectional Analyses of Google Ratings (Preprint)

2021 ◽  
Author(s):  
Hari Ramasubramanian ◽  
Satish Joshi ◽  
Ranjani Krishnan
Keyword(s):  
Application Programming Interface ◽  
Hospital Quality ◽  
Rating System ◽  
Cross Sectional ◽  
Quality Performance ◽  
Quality Ratings ◽  
Before And After ◽  
Fractional Response ◽  
The Individual ◽  
Hospital Compare

BACKGROUND Popular online portals provide free and convenient access to user-generated quality reviews. Centers for Medicare and Medicaid Services (CMS) also provide patients with Hospital Compare Star Ratings (HCSR), a single public measure of hospital quality aggregating multiple quality dimensions. Consumers often use crowdsourced hospital ratings on platforms such as Google to select hospitals, but it is unknown if these ratings reflect a comprehensive measure of clinical quality. OBJECTIVE We analyze if Google online quality ratings, which reflect the wisdom of the crowd, are associated with HCSR, which reflect the wisdom of the experts. CMS revised the methodology of assigning star ratings to hospitals. Therefore, we analyze these associations before and after the 2021 revisions of the CMS rating system. METHODS We extracted Google ratings using Application Programming Interface (API) in June 2020. The HCSR data of April 2020 (before the revision of HCSR methodology) and April 2021 (after the revision of HCSR methodology) were obtained from CMS’ Hospital Compare (HC) website. We also extracted scores for the individual components of hospital quality for each of the hospitals in our sample using the code provided by HC. Fractional Response Model (FRM) was used to estimate the association between Google Ratings and HCSR and individual components of quality. RESULTS Results indicate that Google ratings are statistically associated with HCSR (P<.001) after controlling for hospital level effects. A one star improvement in CMS ratings before the change in methodology (after the change in methodology) is expected to increase the Google ratings by 0.145 (0.135) on average (95% CI 0.127- 0.163; P<.001, 95% CI 0.116-0.153; P<.001). The analyses with individual components of hospital quality reveal that Google ratings are not associated with components of HCSR that require medical expertise such as ‘Safety of care’ or ‘Readmissions’. The revised CMS rating system ameliorates previous partial inconsistencies in association between Google ratings and component scores of HCSR. CONCLUSIONS Overall, crowd sourced Google hospital ratings are informative about expert CMS hospital quality ratings and several individual quality components that are easier for patients to evaluate. Therefore, hospitals should not expect improvements in quality metrics that require expertise to assess such as safety of care and readmission to result in improved Google star ratings. Hospitals can benefit from using crowd-sourced ratings as timely, easily available, and dynamic indicators of their quality performance.

scholarly journals Relationship of Hospital Star Ratings to Race, Education, and Community Income

2020 ◽  
Vol 15 (10) ◽  
pp. 588-593
Author(s):  
Bo Shi ◽  
Christopher King ◽  
Sean Shenghsiu Huang
Keyword(s):  
Educational Attainment ◽  
Multinomial Logistic Regression ◽  
Hospital Quality ◽  
Minority Population ◽  
Lower Income ◽  
Community Characteristics ◽  
Cross Sectional ◽  
Quality Ratings ◽  
Relationship Of ◽  
Racial Ethnic

INTRODUCTION: The Centers for Medicare & Medicaid Services (CMS) publishes hospital quality ratings to provide more transparent and useable quality information to patients and stakeholders. However, there is a gap in the literature regarding the geographic distribution of the hospitals with higher star ratings. In this paper, we focus on the associations between star ratings and community characteristics, including racial/ethnic mix, household income, educational attainment, and regional difference. METHODS: A retrospective study and cross-sectional logistic and multinomial logistic regression analyses. RESULTS: According to the multivariate regression results, hospitals in areas with lower income, lower educational attainment, and higher minority population shares have lower quality ratings (lower income: odds ratio [OR] 0.67; 95% CI, 0.49-0.91; lower education: OR 0.66; 95% CI, 0.51-0.85; higher minority: OR 0.52; 95% CI, 0.40-0.69). Compared with hospitals in the Midwest, hospitals in Northeast, South, and West regions have lower quality ratings (Northeast: OR 0.37; 95% CI, 0.25-0.56; South: OR 0.68; 95% CI, 0.51-0.91; West: OR 0.69; 95% CI, 0.49-0.97). DISCUSSION AND CONCLUSION: Overall, our results show that hospitals with higher star ratings are less likely to be located in communities with higher minority populations, lower income, and lower levels of educational attainment. Findings contribute to the discussion of integrating social factors in hospital quality star rating calculation methodologies.

scholarly journals Neighborhood Disadvantage and Hospital Quality Ratings in the Medicare Hospital Compare Program

Medical Care ◽  
2020 ◽  
Vol 58 (4) ◽  
pp. 376-383 ◽  
Author(s):  
John Fahrenbach ◽  
Marshall H. Chin ◽  
Elbert S. Huang ◽  
Mary K. Springman ◽  
Stephen G. Weber ◽  
...  
Keyword(s):  
Neighborhood Disadvantage ◽  
Hospital Quality ◽  
Quality Ratings ◽  
Hospital Compare

scholarly journals Comparing the Quality of Life of Patients Requesting Dental Implants Before and After Implant

2017 ◽  
Vol 11 (1) ◽  
pp. 485-491 ◽  
Author(s):  
Naser Sargolzaie ◽  
Amir Moeintaghavi ◽  
Hamid Shojaie
Keyword(s):  
Quality Of Life ◽  
Dental Implants ◽  
Daily Practice ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Working At Home ◽  
Before And After ◽  
And Gender ◽  
The Individual

Background and Objectives: Tooth loss is a serious life event that impairs two important functions, namely, eating and speaking, and has significant side effects on different aspects of quality of life. These effects are internalized by the individual. The present study aimed to compare the quality of life (QOL) of patients requesting dental implants before and after implant. Materials and Methods: This analytical cross-sectional study was conducted on patients referred to the Mashhad faculty of Dentistry and private clinics with dental implants in 2015. Patient Quality Of Life (QOL) was assessed using the Oral Impact on Daily Practice (OIDP) questionnaire. Data were analyzed using SPSS software. Results: In this study, the most common problems reported by patients were eating (78%), smiling, laughing, and embarrassment (53%) before surgery. The quality of life associated with eating; speaking clearly; clean teeth or dentures; light physical activities, such as working at home, going out to work or meeting others; smiling; laughing; showing teeth without discomfort and embarrassment; emotional conditions, such as becoming upset quicker than usual, enjoying communication with others (i.e., friends, relatives and neighbors); and job-related activities significantly increased after surgery, but QOL associated with the amount of sleep and resting did not improve. No significant association was noted between quality of life after implantation and place of residence, education and gender. Conclusion: In this study, implants had a favorable impact on a patient’s quality of life.

Peningkatan Pengetahuan Kader tentang Deteksi Dini Kesehatan Jiwa melalui Pendidikan Kesehatan Jiwa

2019 ◽  
Vol 1 (1) ◽  
pp. 33-40
Author(s):  
Terri Febrianto ◽  
Livana PH ◽  
Novi Indrayati
Keyword(s):  
Mental Health ◽  
Health Education ◽  
Early Detection ◽  
Health Knowledge ◽  
Sampling Technique ◽  
Wilcoxon Test ◽  
P Value ◽  
Cross Sectional ◽  
Before And After ◽  
The Individual

Kesehatan jiwa adalah kondisi dimana seorang individu dapat berkembang secara fisik, mental, spiritual, dan sosial sehingga individu tersebut menyadari kemampuan yang dimiliki, dapat megatasi tekanan, dapat bekerja secara produktif, dan mampu memberikan kontribusi untuk komunitasnya. Kondisi perkembangan yang tidak sesuai pada individu disebut gangguan jiwa. Pendidikan kesehatan jiwa merupakan upaya untuk mempengaruhi atau mengajak orang lain baik individu, kelompok, atau masyarakat agar melaksanakan perilaku sehat jiwa. Kemampuan masyarakat dapat ditingkatkan melalui pendidikan kesehatan khususnya mendeteksi dini masalah kesehatan jiwa. Penelitian ini merupakan penelitian kuantitatif dengan pendekatan cross sectional , sampel yang digunakan sebanyak 62 responden dengan teknik sampling Purposive Sampling. Penelitian ini menunjukkan usia kader kesehatan jiwa di Desa Banyutowo mayoritas berusia 47 tahun. Mayoritas responden adalah perempuan 72,6%,  dan mayoritas ekerjaan responden adalah wiraswasta 90,3%. Hasil uji wilcoxon didapatkan nilai signifikan dengan p value 0,000 < 0,05, yang artinya terdapat pengaruh signifikan dari tingkat pengetahuan kader sebelum dan sesudah diberikan pendidikan kesehatan deteksi dini kesehatan jiwa   Kata kunci: pendidikan kesehatan, kesehatan jiwa, pengetahuan, kader   ABSTRACT Mental health is a condition where an individual can develop physically, mentally, spiritually, and socially so that the individual is aware of his abilities, can overcome stresses, can work productively, and be able to contribute to his community. Development conditions that are not suitable for individuals are called mental disorders. Mental health education is an attempt to influence or invite other people, individuals, groups, or communities to carry out healthy mental behaviors. Community capacity can be improved through health education, especially early detection of mental health problems.This study is a quantitative study with a cross sectional approach, with 62 respondents using the Pourposive Sampling sampling technique. This study shows that the majority of mental health cadres in Banyutowo Village are 47 years old. The majority of respondents were women 72.6%, and the majority of respondents were 90.3% self-employed. The results of the Wilcoxon test obtained a significant value with p value 0,000 <0,05, which means that there was a significant influence on the level of knowledge of cadres before and after being given mental health early detection health education in Banyutowo Kendal Village. To the next researcher, it is expected to be able to carry out further research to find out the factors that influence people's disinterest in becoming health cadres and are expected to pay attention to the situation that will be examined and understand the condition of the community.   Keywords: health education, mental health, knowledge, cadre

Acoustic Airway Profiles in Unilateral Cleft Palate Patients

1999 ◽  
Vol 36 (5) ◽  
pp. 434-440 ◽  
Author(s):  
Martin Kunkel ◽  
Ulrich Wahlmann ◽  
Wilfried Wagner
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Contralateral Side ◽  
Cross Sectional ◽  
Topographic Information ◽  
Wide Range ◽  
Before And After ◽  
The Individual ◽  
The University

Objective: This study investigates the nasal airway in unilateral cleft palate patients by means of a noninvasive, objective diagnostic method that provides topographic information about the airway profile. Design: A consecutive sample of patients was measured. Setting: Cleft palate rehabilitation center of the University of Mainz, Germany. Patients: Forty-nine subjects were investigated: 34 full-grown patients with complete unilateral cleft lip and palate and 15 controls with subjective normal nasal patency. Intervention: A transnasal series of three acoustic measurements of nasal volume was performed per nostril; measurements were taken both before and after decongestion with 0.3 mg xylometazoline per nostril. Minimum cross-sectional area, nasal volume, and decongestion capacity were calculated for both the cleft side and the contralateral side and for both nasal sides in controls. Results: Pathologic obstructions (<0.4 cm2) were detected on the cleft side in 75% of patients but were detected in only 15% of patients on the contralateral side (p < .001). The valve area of the cleft side (0.32 ± 0.2 cm2) yielded significantly (p < .001) lower cross-sectional values compared with the contralateral side (0.56 ± 0.1 cm2). Total nasal volume was determined to be 35% smaller on the cleft side (p < .001). Significantly higher decongestion capacity was verified on the cleft side, thus indicating mucosal hypertropy. Conclusion: Despite a wide range of interindividual variability, we recognized a characteristic “descending W” airway pattern in cleft palate patients. Acoustic rhinometry seems to be a powerful tool for acquiring topographic information about the individual airway profile. It has proven helpful in visualizing the location and amount of pathologic obstructions, rendering it especially useful for preoperative investigation and quality control in corrective cleft nose surgery.

scholarly journals Factors Analyze on the Performance of Nurses in the Implementation of Patient Safety

2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Ida Sukaesi
Keyword(s):  
Patient Safety ◽  
Quality Care ◽  
Sampling Technique ◽  
High Quality ◽  
Cross Sectional ◽  
Quality Performance ◽  
Near Misses ◽  
Calculation Results ◽  
The Individual ◽  
Safety Knowledge

Nurse have an important good role for safety of patients by monitoring the patients' condition to prevent the occurrence of incidents, provide health education, detect faults and near misses, and perform other tasks to solve a problem of the patients by high-quality care. The problems have been existing in ER related to the implementation of patient safety is that the patient safety has not been accomplished in accordance with the SPO and Patient Safety Guide. The purpose of this study is to analyze the factors associated with the performance of nurses in the implementation of patient safety. The research uses analytical descriptive design with cross sectional approach. The number of samples used is 23 respondents with total sampling technique . The calculation results of multiple regression analysis of patient safety knowledge factors have the most dominant influence with standardized ß coefficient of 0.678 and 0.329 meaning that it has a significant effect while the supervision does not. Optimizing the development of the individual nurse requires efforts to increase knowledge and skills in the context of patient safety; therefore, they are able to show high-quality performance.

Abstract 256: The Effect Of Credentialed Cardiovascular Pharmacists On Process Measures And Outcomes In Myocardial Infarction And Heart Failure

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Michael P Dorsch ◽  
Jennifer Lose ◽  
Robert J DiDomenico
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Process Of Care ◽  
Cross Sectional ◽  
Process Measures ◽  
Matched Case ◽  
Improved Performance ◽  
The Individual ◽  
Hospital Compare ◽  
Control Study

Background: Although cardiology pharmacist credentialing is strongly advocated, there is little to no evidence suggesting board certification improves patient outcomes. The purpose of this study is to determine if institutions with inpatient cardiology credentialed pharmacists exhibit improved quality measure performance for myocardial infarction and heart failure compared to institutions without inpatient cardiology credentialed pharmacists. Methods: This is a multicenter, retrospective, cross-sectional, matched case-control study. The cardiology credentialing studied was the Board of Pharmaceutical Specialties (BPS) Added Qualification in Cardiology (AQCV). A list of AQCV pharmacists was derived from publically available data on the BPS website in July 2011 for inclusion in the study. Each case AQCV pharmacist hospital was matched to a hospital without an AQCV pharmacist in a 1 to 3 manner. Control hospitals were matched by geographical region, number of cardiovascular discharges, and the type of hospital. The proportion of patients meeting HF and AMI process of care measures, 30-day readmission rate, and 30 day mortality for each hospital were determined from the website Hospital Compare. Results: The 34 AQCV hospitals were matched to 102 non-AQCV hospitals. Hospitals that employed inpatient AQCV pharmacists performed better on a composite of 5 medication-related process of care measures compared to hospitals that do not employ inpatient AQCV pharmacists (OR 1.41, 95% CI 1.25-1.58, p <0.0001, p<0.001 for heterogeneity). The individual measures that were improved were aspirin on discharge for AMI and ACEi/ARB on discharge for HF. Thirty day readmission and mortality for HF and AMI were not different in hospitals that employed inpatient AQCV pharmacists compared to those that do not. Conclusions: Hospitals that employ inpatient AQCV credentialed pharmacists have improved performance on process of care measures compared to those that do not employ AQCV credentialed pharmacists. This analysis did not demonstrate that inpatient AQCV credentialed pharmacists improve readmissions or mortality for AMI and HF.

Health Status of Senior Citizens: A Cross-sectional study

2020 ◽  
Vol 11 (01) ◽  
Author(s):  
Priyanka Beniwal ◽  
Chandrakala Singh
Keyword(s):  
Health Status ◽  
Senior Citizens ◽  
Total Sample ◽  
Cross Sectional Study ◽  
Age Group ◽  
Poor Health Status ◽  
Cross Sectional ◽  
Males And Females ◽  
The Individual ◽  
Average Health

Aging is a series of processes that begin with life and continue throughout the lifecycle. It represents the closing period in the lifespan, a time when the individual looks back on life, lives on past accomplishments and begins to finish off his life course. It represents the accumulation of changes in person over time. The study aims to investigate the health status of senior citizens. The present study was carried out in Hisar and Sirsa district of Haryana state. A total of 400 elderly equally representing both males and females of age group 65-70 years were selected randomly for the study. Modified inventory developed by Khan and Lal (2011) was used to assess health status of senior citizens. The results of the study elucidated that health status of senior citizens depicted that 54.25 per cent of the total respondents had average health status followed by good (25.25%) and poor health status (20.50%). The most common health problems reported by the senior citizens were joint pains, back pains, blood pressure, and chest pain etc. Gender wise comparison of total sample further pointed out that females were poor in their health against males.

Sign in / Sign up

Export Citation Format

Share Document