JMIR Publications

ABSTRACT

Background:

Patients may use two information sources about a provider’s quality: online physician reviews are written by patients to reflect their subjective experience; report cards, on the other hand, are based on objective health outcomes.

Objective:

To examine and compare the impacts of online ratings and report cards on patient choice of cardiac surgeon.

Methods:

We obtained ratings from a leading physician review platform (Vitals.com), report card scores from Pennsylvania Cardiac Surgery Reports, and information about patients’ choices of surgeons from inpatient records on coronary artery bypass graft surgeries done in Pennsylvania during 2008-2017. We scraped all reviews on Vitals for surgeons who performed CABG in Pennsylvania during our study period. We linked the average overall rating and the most recent report card score at the time of a patient’s surgery to the patient’s record based on the surgeon’s name. We used random coefficient logit models to examine the impact of receiving a high online rating and a high report card score on patient choice of surgeon for coronary artery bypass graft (CABG) surgeries.

Results:

We found that a high online rating and report card score both have positive and significant effects on patient utility, with limited variation in preferences across individuals. About 56.7% of patients considered no information on Vitals better than a low rating; in contrast, the corresponding figure was 15.3% for report cards scores. The findings were robust to alternative specifications and surgeon-level time-invariant unobserved characteristics, and were not explained by insurance types, a referral effect, or admission status. Our results also showed that the interacted effect of rating information and a time trend was positive for online ratings, but negative for report cards.

Conclusions:

A patient’s choice of surgeon is affected by both types of rating information, but over the past decade online ratings have become more influential, while the effect of report cards has declined. Our findings call for information provision strategies that incorporate the advantages of both online ratings and report cards.