To-date, the measurement of interpersonal racism is limited in health care because of its subjective nature. The inability to measure interpersonal racism at the local level has limited the ability to improve racist patient experiences within health care. Prior work has demonstrated consumer reviews’ unique ability to highlight novel concepts not captured in traditional performance metrics and to impact consumer hospital selection. Consumer reviews offer an opportunity to understand subjective perceptions of racism in health care in an unstructured and anonymous format. To demonstrate the potential role of consumer reviews in studying interpersonal racism in health care, researchers explored reviews of hospitals to better understand how consumers perceive and report racism.
A qualitative study, published in JAMA Network Open, studied Yelp consumer reviews on United States hospitals published between January 2010 to January 2020. During the study period, over 90,000 online consumer reviews of US hospitals were reviewed. Of all reviews obtained, 260 reviews explicitly cited racism in 190 hospitals spread across 33 states.
The study found that (1) it is feasible to identify acts of interpersonal racism in health care using qualitative methods on consumer reviews, (2) racism in health care can involve critical organization personnel outside of the clinical staff, and (3) racism can be bidirectional, affecting both patients and hospital employees. These detailed reviews likely represent the tip of the iceberg, and future efforts to supplement this data with existing hospital-based reporting measures, such as human resources reports, may help to further explore concepts such as patient-to-employee racism. Additionally, experiences of interpersonal racism are just one aspect of racism in health care, and future work is needed to couple the subjective measures of interpersonal racism with objective measures of structural racism to establish a hospital quality composite metric of racism.
- Evaluation of Online Consumer Reviews of Hospitals and Experiences of Racism Using Qualitative Methods. JAMA Network Open. September 22 2021