ArticleJAMA network open2022
Reporting of Discrimination by Health Care Consumers Through Online Consumer Reviews.
Article in JAMA network open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Essential elements and outcomes of psychological safety in the healthcare practice setting: A systematic review.Applied nursing research : ANR · 2025Pooled it
- Eliciting patient past experiences of healthcare discrimination as a potential pathway to reduce health disparities: A qualitative study of primary care staff.Health services research · 2025Article
- Exploring sociodemographic disparities in diagnostic problems and mistakes in the quest for diagnostic equity: insights from a national survey of patient experiences.Frontiers in public health · 2025Article
- Disparities by Race and Urbanicity in Online Health Care Facility Reviews.JAMA network open · 2024Article
- Google star ratings of Canadian hospitals: a nationwide cross-sectional analysis.BMJ open quality · 2024Article
- Racism against healthcare users in inpatient care: a scoping review.International journal for equity in health · 2024Article
- Discriminatory Healthcare Experiences and Medical Mistrust in Patients With Serious Illness.Journal of pain and symptom management · 2024Article
- Theories for interventions to reduce physical and verbal abuse: A mixed methods review of the health and social care literature to inform future maternity care.PLOS global public health · 2023Review
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
importanceLittle is known about how discrimination in health care relates to inequities in hospital-based care because of limitations in the ability to measure discrimination. Consumer reviews offer a novel source of data to capture experiences of discrimination in health care settings.
objectiveTo examine how health care consumers perceive and report discrimination through public consumer reviews. DESIGN, SETTING, AND
participantsThis qualitative study assessed Yelp online reviews from January 1, 2011, to December 31, 2020, of 100 randomly selected acute care hospitals in the US. Word filtering was used to identify reviews potentially related to discrimination by using keywords abstracted from the Everyday Discrimination Scale, a commonly used questionnaire to measure discrimination. A codebook was developed through a modified grounded theory and qualitative content analysis approach to categorize recurrent themes of discrimination, which was then applied to the hospital reviews. EXPOSURES: Reported experiences of discrimination within a health care setting. MAIN OUTCOMES AND MEASURES: Perceptions of how discrimination in health care is experienced and reported by consumers.
resultsA total of 10 535 reviews were collected. Reviews were filtered by words commonly associated with discriminatory experiences, which identified 2986 reviews potentially related to discrimination. Using the codebook, the team manually identified 182 reviews that described at least 1 instance of discrimination. Acts of discrimination were categorized by actors of discrimination (individual vs institution), setting (clinical vs nonclinical), and directionality (whether consumers expressed discriminatory beliefs toward health care staff). A total of 53 reviews (29.1%) were coded as examples of institutional racism; 89 reviews (48.9%) mentioned acts of discrimination that occurred in clinical spaces as consumers were waiting for or actively receiving care; 25 reviews (13.7%) mentioned acts of discrimination that occurred in nonclinical spaces, such as lobbies; and 66 reviews (36.3%) documented discrimination by the consumer directed at the health care workforce. Acts of discrimination are described through 6 recurrent themes, including acts of commission, omission, unprofessionalism, disrespect, stereotyping, and dehumanizing. CONCLUSIONS AND RELEVANCE: In this qualitative study, consumer reviews were found to highlight recurrent patterns of discrimination within health care settings. Applying quality improvement tools, such as the Plan-Do-Study-Act cycle, to this source of data and this study's findings may help inform assessments and initiatives directed at reducing discrimination within the health care setting.
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Registered trials
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