Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Apr 6, 2021
Date Accepted: Aug 26, 2021
What Yelp Effect? An Analysis of Hundreds of Thousands of Online Reviews of Urgent Cares
ABSTRACT
Background:
Providers of on-demand care, such as in urgent care, may prescribe antibiotics unnecessarily because they fear receiving negative reviews online from unsatisfied patients – the so-called “Yelp Effect”. This effect is hypothesized to be a significant driver of inappropriate antibiotic prescribing, exacerbating antibiotic resistance.
Objective:
In this study, we aim to determine the frequency with which patients left negative reviews online after having expected, but not received, antibiotics in an urgent care setting.
Methods:
We obtained a list of 8662 urgent care facilities from the Yelp Application Programming Interface (API). Using this list, we automatically collected 481825 online reviews from Google Maps between January 21st, and Feb 10th, 2019. We used machine learning algorithms to summarize the contents of these reviews. Additionally, 200 randomly sampled reviews were analyzed by four annotators to verify the types of messages present and whether they were consistent with the “Yelp Effect”.
Results:
We collected 481825 reviews, of which 1696 (95% CI: 1240-2152) exhibited the “Yelp effect”. Instead, negative reviews primarily identified operations issues: wait times, rude staff, billing, and communication.
Conclusions:
Urgent care patients rarely express expectation for antibiotics in negative online reviews. Thus, our findings do not support an association between lack of antibiotic prescriptions and negative online reviews. Rather, patient dissatisfaction in urgent care was most strongly linked to operations issues that are not related to the clinical management plan. Clinical Trial: This research was approved by The George Washington University Committee on Human Research, Institutional Review Board (IRB), FWA00005945 (IRB #180804).
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