JMIR Publications

ABSTRACT

Background:

Online healthcare complaints are currently gaining in popularity. A generic framework based on patient centeredness may be helpful to identify what is generalizable issues of patient online complaints across multiple settings and examine whether the determinants of patient-centered care (PCC) are mirrored in determinants of patient experience as well.

Objective:

The objective of our study was to develop a taxonomy framework for patient online complaints based on patient centeredness, and to examine whether the determinants of Patient-Centered Care (PCC) mirror the determinants of patient experiences.

Methods:

First, the Best Fit Framework Synthesis (BFSP) technique was applied to develop the proposed priori framework. Second, electronic databases, including ISI Web of Science, Scopus and PubMed, were searched for articles published between 2000 to June 2018. Studies were only included if they collected primary quantitative data on patients’ online complaints. Third, a deductive and inductive thematic analysis approach was adopted to code the themes of recognized complaints into the framework.

Results:

In total, 17 studies from five countries were included in this study. Patient online complaint taxonomies and theme terms varied. According to our framework, patients express the most dissatisfaction with ‘patient-centered processes’ (101549, 49.7%), followed by ‘prerequisites (appropriate skills and knowledge of e.g., physicians etc.)” (50563, 24.7%) and ‘the care environment’ (48563, 23.8%). The least dissatisfied theme regarded ‘expected outcomes’ (3651, 1.8%). People expressed little dissatisfaction with ‘expanded’ PCC dimensions, such as ‘involvement of family and friends’ (591, 0.3%), etc. Variation in the concerns across different countries’ patients were also observed.

Conclusions:

Online complaints made by patients are considered of major value to health care providers, regulatory bodies, and patients themselves. Our patient-centered care framework can be applied to analyze them under a wide range of conditions, treatments and countries. This review has shown significant heterogeneity of patients’ online complaints across different countries.