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The Influence of Consumer Ratings on Healthcare Quality Perception
Nida Ahmad
HAP 465
Professor Braithwaite
September 27, 2023
2
Do Consumer Ratings give a false perception of Care?
Background
In recent years, the healthcare industry has witnessed a notable shift in the way patients
assess the quality of care they receive. Increasingly, consumers turn to online platforms, such as
hospital review websites and social media, to share their experiences and rate healthcare
providers. While the intention behind these consumer ratings is to empower patients and offer
transparency in healthcare, it is crucial to examine whether they consistently provide an accurate
reflection of the quality of care. This background section explores the dynamics of consumer
ratings in healthcare and the various factors that can impact their validity.
The Rise of Consumer Ratings in Healthcare
Consumer ratings in healthcare have gained significant prominence due to the
proliferation of online review platforms and the growing emphasis on patient-centered care.
Patients and their families, armed with smartphones and internet access, now have the means to
instantly rate and review healthcare facilities, physicians, nurses, and other healthcare
professionals. This democratization of healthcare feedback has empowered consumers to voice
their opinions and share their experiences openly.
Healthcare organizations have also recognized the value of patient feedback in improving
the quality of care. According to Sotto-Santiago et al. (2019), patient’s ratings of their experience
are a vital source of data and information on the competitive advantages of health systems that
inform their actions to deliver quality patient-centered care to their patients. Many hospitals and
clinics actively solicit patient ratings and feedback through surveys and online platforms. These
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ratings are often used for internal quality improvement efforts and to enhance patient satisfaction
(Arboleda, 2023).
The Factors Influencing Consumer Ratings
Data obtained from patient satisfaction assessments should be considered in the
identification of training requirements for nurses, and initiatives for in-service training should be
organized to improve nurses’ competence and proficiency in care planning (Karaca & Durna,
2019). It can be challenging to determine and use fair and achievable ratings for diverse
healthcare workers that would generate the correct data for informing quality care practices
(Poole & McDougle, 2020). While the intention behind consumer ratings is commendable, it is
essential to recognize that several factors can influence the accuracy and reliability of these
ratings. Some of these factors include:
Patient Expectations
Patient expectations can heavily influence consumer ratings. Patients who enter
healthcare interactions with high expectations are more likely to give positive ratings, even if the
care they receive meets basic standards. Conversely, patients with lower expectations may rate
the same care as exceptional.
Biases
Patients’ perceptions and biases can also impact their ratings. These biases may be related
to factors such as age, gender, race, or socioeconomic status. Biased ratings can lead to
disparities in how healthcare providers are evaluated.
Prior Experiences
Patients’ prior experiences with healthcare, whether positive or negative, can color their
perception of subsequent encounters. A patient who has had a history of positive experiences
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may be more forgiving of minor issues, while one with negative experiences may be quick to
assign lower ratings.
External Factors
External factors, such as online reviews from other patients, media coverage, or social
media discussions, can influence consumer ratings. These external influences can create a ripple
effect, either bolstering or tarnishing a healthcare provider’s reputation.
Emotional States
Patients’ emotional states at the time of rating can sway their assessments. For instance, a
patient who is feeling anxious, upset, or elated may not provide an objective evaluation of their
healthcare experience.
Limited Understanding of Medical Care
Patients may lack a comprehensive understanding of medical care processes and
standards. Consequently, their ratings may be based on layperson’s perceptions rather than
clinical expertise.
Selection Bias
Online review platforms may suffer from selection bias, as dissatisfied patients may be
more motivated to leave reviews than satisfied ones. This bias can lead to an overrepresentation
of negative experiences.
The Use of Consumer Ratings in Healthcare Quality Assessment
Consumer ratings have increasingly become part of healthcare quality assessment efforts.
However, it is essential to recognize their limitations when interpreting their role in gauging
healthcare quality accurately. Healthcare organizations and policymakers must navigate these
nuances carefully.
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In conclusion, the rise of consumer ratings in healthcare reflects a significant shift in how
patients engage with and evaluate their healthcare experiences. According to Shah et al. (2021),
patient feedback and ratings are part of the leading indicators of service quality and guide efforts
to address efficiency and viability issues in any healthcare setting. While these ratings offer
valuable insights and promote transparency, it is crucial to acknowledge the factors that can
influence their accuracy. The next sections of this position paper will explore the perspectives
that argue for and against the reliability of consumer ratings in assessing healthcare quality.
Ultimately, this discussion underscores the need for a balanced approach when considering
consumer ratings as indicators of healthcare quality.
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References
Arboleda, A. M. (2023). Satisfaction with life and perception of healthcare services.
International Journal of Hospitality Management, 110, 103450.
https://doi.org/10.1016/j.ijhm.2023.103450
Karaca, A., & Durna, Z. (2019). Patient Satisfaction with the Quality of Nursing Care. Nursing
Open, 6(2), 535–545. https://doi.org/10.1002/nop2.237
Poole, K., & McDougle, L. (2020). There is Still Bias in Patient Satisfaction Data. Journal of the
National Medical Association, 112(3), 242. https://doi.org/10.1016/j.jnma.2020.03.004
Shah, A. M., Yan, X., Tariq, S., & Ali, M. (2021). What Patients Like or Dislike in Physicians:
Analyzing Drivers of Patient Satisfaction and Dissatisfaction Using a Digital Topic
Modeling Approach. Information Processing & Management, 58(3), 102516.
https://doi.org/10.1016/j.ipm.2021.102516
Sotto-Santiago, S., Slaven, J. E., & Rohr-Kirchgraber, T. (2019). (Dis)Incentivizing Patient
Satisfaction Metrics: The Unintended Consequences of Institutional Bias. Health Equity,
3(1), 13–18. https://doi.org/10.1089/heq.2018.0065
Assignment #1
HAP 465
Format this reference in
APA 7
What kind of document
is this? What makes it
credible?
Explain why this
reference is relevant to
your topic
Indicate where you plan
to use this reference in
your paper
Provide an example of an
in-text citation for this
source
Reference #1
Bhandari, N., Scanlon, D. P., Shi, Y., & Smith, R. A. (2019). Why do so few
consumers use health care quality report cards? A framework for
understanding the limited consumer impact of comparative quality
information. Medical Care Research and Review 76(5), 515-537.
https://doi.org/10.1177/1077558718774945
The document is a peer-reviewed research article that was written by authors
with expertise on the topic and who presented objective perspectives on the
issue. Also, the credibility of this document is characterized by the authors’
clear and concise presentation of the information, adherence to the
professional standards for journal articles, and currency of the information.
This reference source is relevant to the topic due to its focus on the
consumer’s use of provider quality information to inform their purchasing
decisions and their impacts on the providers’ approaches to making
adjustments to their practices. Hence, this reference material is relevant for
generating both supporting or opposing evidence on the impacts of consumer
ratings on the false perceptions of quality of care.
Due to the quality of evidence from this source on consumer’s use of
providers’ report cards to guide their healthcare decisions, I plan to use this
reference as part of the supporting evidence to the views of other reference
materials
Bhandari et al. (2018) state that despite the low appeal of current provider
quality information to health consumers, there is still a significant number
who use them to inform their purchasing decisions.
Format this reference in
APA 7
What kind of document
is this? What makes it
credible?
Explain why this
reference is relevant to
your topic
Indicate where you plan
to use this reference in
your paper
Provide an example of an
in-text citation for this
source
Format this reference in
APA 7
What kind of document
is this? What makes it
credible?
Explain why this
reference is relevant to
your topic
Indicate where you plan
to use this reference in
your paper
Provide an example of an
in-text citation for this
source
Reference #2
Arboleda, A. M. (2023). Satisfaction with life and perception of healthcare
services. International Journal of Hospitality Management, 110, 103450 103516. https://doi.org/10.1016/j.ijhm.2023.103516
The document is a peer-reviewed research article that was written by an
author with expertise on the topic and who started the study’s objectives,
presented facts, and supported his claims with evidence from other peerreviewed articles. Similarly, this article is a credible source of information
because it is a recent publication on the topic and demonstrates the author’s
adherence to the professional standards for research publications.
The information in the reference is relevant to the topic because it describes
the association between patient satisfaction and quality of care that contribute
to the perception of the health system. In this regard, this reference provides
evidence to support arguments that consumer ratings do not lead to a false
perception of the quality of care.
The reference would be used to support the views on the positive impacts of
consumer ratings on measures and strategies for delivering quality care
services to patients in any healthcare setting.
Arboleda (2023) states that healthcare organizations perform long-term
assessments that enable them to meet regulatory requirements for quality
services and develop and implement initiatives to attract and maintain
patients’ loyalty (p.103450).
Reference #3
Endeshaw, B. (2021). Healthcare service quality-measurement models: a
review. Journal of Health Research, 35(2), 106-117.
https://doi.org/10.1108/JHR-07-2019-0152
The document is a peer-reviewed research article that was written by an
author with expertise on the topic and who started the study’s objectives,
presented facts, and supported claims with evidence from other peer-reviewed
articles. Also, the credibility of this document is characterized by its date of
publication within the past five years, the author’s clear and concise
presentation of the information, and its adherence to the professional
standards for journal articles.
This reference is relevant to the topic due to its description of the
measurement models for the quality of healthcare services and their
limitations for guiding consumer ratings of quality care from their providers.
The information from this article will be used to demonstrate how consumer
ratings can lead to false perceptions of the quality of care since the
measurement models are outdated and ineffective.
According to Endeshaw (2021), “the dimensions of quality and an approach to
the measurement of healthcare service quality are still not settled upon”
(p.112).
Format this reference in
APA 7
What kind of document
is this? What makes it
credible?
Explain why this
reference is relevant to
your topic
Indicate where you plan
to use this reference in
your paper
Provide an example of an
in-text citation for this
source
Format this reference in
APA 7
What kind of document
is this? What makes it
credible?
Explain why this
reference is relevant to
your topic
Indicate where you plan
to use this reference in
your paper
Provide an example of an
in-text citation for this
source
Reference #4
Karaca, A., & Durna, Z. (2019). Patient satisfaction with the quality of
nursing care. Nursing Open, 6(2), 535-545. https://doi.org/10.1002/nop2.237
This document is an original research article that is peer-reviewed, published
within the past five years, and authored by two experts in the field. Also, this
document is a credible source of information because its facts and findings are
supported by sufficient from multiple research studies, contains clear purpose
statements, and well-written clear and concise contents.
The relevance of this reference to the topic is characterized by its detailed
description of the association between patient satisfaction data and nursing
service quality in any clinical setting.
The contents and information from this reference material would be used to
provide background information on the importance of consumer ratings to
efforts to deliver quality care to patients.
Karaca and Durna (2019) state that patients’ responses to patient satisfaction
surveys should inform the changes and priorities in service areas that affect
quality of care.
Reference #5
Sun, Y., Zhang, Y., Gwizdka, J., & Trace, C. B. (2019). Consumer evaluation
of the quality of online health information: Systematic literature review of
relevant criteria and indicators. Journal of Medical Internet Research, 21(5),
e12522 -e12530. https://doi.org/10.2196/12522
This document is an original research article that is peer-reviewed, published
within the past five years, and authored by experts in the field with similar
publications on the topic. Also, this document is a credible source of
information because its facts and findings are supported by sufficient from
multiple research studies, contains clear purpose statements, and well-written
clear and concise contents.
The relevance of this reference to the topic is characterized by its detailed
description of the suitability and relevance of existing instruments for
collecting consumer ratings of the quality of care from their providers.
The contents and information from this reference material would be used to
provide background information on the importance of consumer ratings to
efforts for delivering quality care to patients.
According to Sun et al. (2019), consumers find it difficult to evaluate the
quality of online health information.
Format this reference in
APA 7
What kind of document
is this? What makes it
credible?
Explain why this
reference is relevant to
your topic
Indicate where you plan
to use this reference in
your paper
Provide an example of an
in-text citation for this
source
Format this reference in
APA 7
What kind of document
is this? What makes it
credible?
Explain why this
reference is relevant to
your topic
Indicate where you plan
to use this reference in
your paper
Provide an example of an
in-text citation for this
source
Reference #6
Poole Jr, K. G., & McDougle, L. (2020). There is still bias in patient
satisfaction data. Journal of the National Medical Association, 112(3), 242242. https://doi.org/10.1016/j.jnma.2020.03.004
This document is a review article that was published within the past three
years and authored by experts in the field with similar publications on the
topic. Also, this document is a credible source of information because its facts
and findings are supported by sufficient from multiple research studies,
contains clear purpose statements, and well-written clear and concise contents
The reference is relevant to the topic because it evidence is useful for
supporting the argument that consumer ratings lead to false perception of the
quality of care due to biases in the data collection process.
The article would be used to support the views on the limitations of the use of
consumer ratings to drive service improvement efforts or implement practices
that lead to the delivery of quality care to patients in any healthcare setting.
Poole Jr, K. G., & McDougle, L. (2020) state that it is difficult to determine
and use fair and achievable ratings for diverse healthcare workers that would
generate the right data for informing quality care practices.
Reference #7
Sotto-Santiago, S., Slaven, J. E., & Rohr-Kirchgraber, T. (2019). (Dis)
incentivizing patient satisfaction metrics: The unintended consequences of
institutional bias. Health Equity, 3(1), 13-18.
https://doi.org/10.1089/heq.2018.0065
The document is a peer-reviewed research article that was written by authors
with expertise on the topic and who presented objective perspectives on the
issue. Also, the credibility of this document is characterized by the authors’
clear and concise presentation of the information, adherence to the
professional standards for journal articles, and currency of the information.
This reference material is relevant for generating opposing evidence on the
impacts of consumer ratings on the false perceptions of quality of care and
supports the views that institutional issues are responsible for the problems
with the wrong application of consumer ratings by healthcare organizations.
The article would be used to oppose the views that consumer ratings
contribute to the false perception of quality of care among healthcare
providers and other stakeholders.
According to Sotto-Santiago et al. (2019), patient’s ratings of their experience
are a vital source of data and information on the competitive advantages of
health systems that inform their actions to deliver quality patient-centered care
to their patients.
Format this reference in
APA 7
What kind of document
is this? What makes it
credible?
Explain why this
reference is relevant to
your topic
Indicate where you plan
to use this reference in
your paper
Provide an example of an
in-text citation for this
source
Format this reference in
APA 7
What kind of document
is this? What makes it
credible?
Explain why this
reference is relevant to
your topic
Indicate where you plan
to use this reference in
your paper
Provide an example of an
in-text citation for this
source
Reference #8
Upadhyai, R., Jain, A. K., Roy, H., & Pant, V. (2019). A review of healthcare
service quality dimensions and their measurement. Journal of Health
Management. https://doi.org/10.1177/0972063418822583
The document is a peer-reviewed research article that was written by authors
with expertise on the topic and who started their study’s objectives, presented
facts, and supported claims with evidence from other peer-reviewed articles.
Also, the credibility of this document is characterized by its date of
publication within the past five years, the author’s clear and concise
presentation of the information, and their adherence to the professional
standards for journal articles.
The reference provides information on the dimension of healthcare service
quality and approaches for measuring them that generate data for informing
improvement actions by healthcare organizations.
The information from this article will be used to demonstrate how consumer
ratings can lead to a false perception of quality of care since the constructs
and measurements do not consider providers’ perspective on the factors that
determine service quality.
According to Upadhyai et al. (2019), the focus on patients’ perspective of
quality is inadequate to inform the practice and models for meeting the
benchmarks and metrics for service quality.
Reference #9
Bayindir, E. E., & Schreyögg, J. (2023). Public reporting of hospital quality
measures has not led to overall quality improvement: Evidence from
Germany: Study examines the impact of public reporting on hospital quality
measures in Germany. Health Affairs, 42(4), 566-574.
https://doi.org/10.1377/hlthaff.2022.00470
The document is a research article that was written by two authors with
expertise on the topic and who presented objective perspectives on the issue.
Also, the credibility of this document is characterized by the authors’ clear
and concise presentation of the information, adherence to the professional
standards for journal articles, and currency of the information.
The reference is relevant to the topic because it provides evidence on how the
different aspects of quality measurement do not lead to improvements that
contribute to quality care of patient.
The contents of this reference material would be used to support the
arguments that consumer ratings are inadequate to inform practice changes or
improvements that lead to quality care.
Bayindir et al. (2023) state that “the quality of care that a hospital provides
can be improved to affect patient selection or to preserve or improve the
institution’s reputation” (p.568).
Format this reference in
APA 7
What kind of document
is this? What makes it
credible?
Reference #10
Shah, A. M., Yan, X., Tariq, S., & Ali, M. (2021). What patients like or
dislike in physicians: Analyzing drivers of patient satisfaction and
dissatisfaction using a digital topic modeling approach. Information
Processing & Management, 58(3), 102516.
https://doi.org/10.1016/j.ipm.2021.102516
Explain why this
reference is relevant to
your topic
This document is an original research article that is peer-reviewed, published
within the past two years, and authored by experts with experience and
authority on the topic area. Also, this document is a credible source of
information because its facts and findings are supported by sufficient from
multiple research studies, contain clear purpose statements, and well-written
clear and concise contents.
This reference material is relevant to the topic through its evidence on the
drivers of positive and negative consumer ratings of their healthcare
providers.
Indicate where you plan
to use this reference in
your paper
Provide an example of an
in-text citation for this
source
The reference material would be used to support or oppose the views that
consumer ratings lead to false perceptions of the quality of care in any
healthcare setting.
According to Shah et al. (2021), patient feedback and ratings are part of the
leading indicators of service quality and guide efforts to address efficiency
and viability issues in any healthcare setting.
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