Tweets about hospital quality: a mixed methods study.

Area of Science:

• Health Services Research
• Digital Health
• Social Media Analysis

Background:

• Patients increasingly use Twitter to share healthcare experiences, offering potential insights into provider quality and service improvement.
• The study investigates the utility of Twitter data for assessing healthcare quality within the English National Health Service.

Purpose of the Study:

• To determine if tweets directed at English National Health Service hospitals contain actionable information on care quality.
• To compare Twitter sentiment regarding hospitals with established patient experience surveys and standardized mortality rates.

Main Methods:

• A mixed-methods approach analyzed 198,499 tweets sent to English hospitals over one year.
• Quantitative analysis was combined with a qualitative content analysis of 1,000 randomly selected tweets.
• Spearman's rank correlation coefficient was used to compare Twitter sentiment with conventional quality metrics.

Main Results:

• 11% of hospital-directed tweets contained care quality information, primarily patient experience (8%).
• Effectiveness and safety comments were less frequent (3%), with 77% of quality-related tweets being positive.
• No significant associations were found between Twitter sentiment and established quality metrics.

Conclusions:

• A small fraction of tweets to hospitals address care quality, and Twitter sentiment does not clearly correlate with traditional quality measures, potentially limiting its role in quality monitoring.
• Despite limitations, tweets offer valuable insights for targeted quality improvement initiatives.
• Policy-maker enthusiasm for social media in quality monitoring requires careful consideration and formal evaluation.