A changing landscape of physician quality reporting: analysis of patients' online ratings of their physicians over a 5-year period.
A changing landscape of physician quality reporting: analysis of patients' online ratings of their physicians over a 5-year period.
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医师质量报告的不断变化的景观：分析患者在5年内对医师的在线评级。
DOI：
10.2196/jmir.2003
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发表时间：
2012-02-24
影响因子：
7.4
通讯作者：
Jha AK
中科院分区：
文献类型：
--
作者：
Gao GG;McCullough JS;Agarwal R;Jha AK
美国人越来越多地发布和咨询在线医生排名，但我们对这种公共医生质量报告的新现象知之甚少。医生们担心这些排名会成为不满患者的发泄渠道。描述患者在线评分随时间推移的趋势，跨专业，以确定哪些医生特征影响在线评分，并检查评分值如何反映医生质量。我们使用了来自RateMDs.com的数据，其中包括2005年至2010年超过386，000个国家的评级，并提供了对患者在线评级演变的见解。我们从美国卫生与公众服务部的地区资源文件中获得了医生人口统计数据。最后，我们将患者的评级与弗吉尼亚医学委员会的医生级数据进行了匹配，并检查了被评级的概率和由此产生的评级水平。我们估计，到2010年1月，每6名美国执业医生中就有1人接受过在线审查。妇产科医生被评定为其他医生的两倍（P <0.001）。在线评价普遍相当积极（平均3.93分，1至5分）。根据弗吉尼亚州的医生人口，长期毕业生更有可能被评为，而近年来毕业的医生获得更高的平均评级（P < .001）。患者对董事会认证的医生（P = 0.04），毕业于高评级医学院的医生（P = 0.002）和没有医疗事故索赔的医生（P = 0.1）的评分略高。在线医生评级正在迅速普及，并变得司空见惯，没有证据表明他们是由不满的病人主导的。存在统计上显着的相关性和医生的经验，董事会认证，教育和医疗事故索赔的评级值之间的相关性，这表明在线评级和医生质量之间的正相关。不过，幅度很小。每位医生的平均评分数仍然很低，大多数评分变化反映了对守时和工作人员的评价。了解它们是否真正反映了更好的护理以及如何使用它们将至关重要。
Americans increasingly post and consult online physician rankings, yet we know little about this new phenomenon of public physician quality reporting. Physicians worry these rankings will become an outlet for disgruntled patients. To describe trends in patients’ online ratings over time, across specialties, to identify what physician characteristics influence online ratings, and to examine how the value of ratings reflects physician quality. We used data from RateMDs.com, which included over 386,000 national ratings from 2005 to 2010 and provided insight into the evolution of patients’ online ratings. We obtained physician demographic data from the US Department of Health and Human Services’ Area Resource File. Finally, we matched patients’ ratings with physician-level data from the Virginia Medical Board and examined the probability of being rated and resultant rating levels. We estimate that 1 in 6 practicing US physicians received an online review by January 2010. Obstetrician/gynecologists were twice as likely to be rated (P < .001) as other physicians. Online reviews were generally quite positive (mean 3.93 on a scale of 1 to 5). Based on the Virginia physician population, long-time graduates were more likely to be rated, while physicians who graduated in recent years received higher average ratings (P < .001). Patients gave slightly higher ratings to board-certified physicians (P = .04), those who graduated from highly rated medical schools (P = .002), and those without malpractice claims (P = .1). Online physician rating is rapidly growing in popularity and becoming commonplace with no evidence that they are dominated by disgruntled patients. There exist statistically significant correlations between the value of ratings and physician experience, board certification, education, and malpractice claims, suggesting a positive correlation between online ratings and physician quality. However, the magnitude is small. The average number of ratings per physician is still low, and most rating variation reflects evaluations of punctuality and staff. Understanding whether they truly reflect better care and how they are used will be critically important.
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