title: Associations between Internet-based patient ratings and conventional surveys of patient experience in the English NHS: an observational study.
abstract: OBJECTIVE
  Unsolicited web-based comments by patients regarding their healthcare are increasing, but controversial. The relationship between such online patient reports and conventional measures of patient experience (obtained via survey) is not known. The authors examined hospital level associations between web-based patient ratings on the National Health Service (NHS) Choices website, introduced in England during 2008, and paper-based survey measures of patient experience. The authors also aimed to compare these two methods of measuring patient experience.
  
  
  METHODS
  The authors performed a cross-sectional observational study of all (n=146) acute general NHS hospital trusts in England using data from 9997 patient web-based ratings posted on the NHS Choices website during 2009/2010. Hospital trust level indicators of patient experience from a paper-based survey (five measures) were compared with web-based patient ratings using Spearman's rank correlation coefficient. The authors compared the strength of associations among clinical outcomes, patient experience survey results and NHS Choices ratings.
  
  
  RESULTS
  Web-based ratings of patient experience were associated with ratings derived from a national paper-based patient survey (Spearman ρ=0.31-0.49, p<0.001 for all). Associations with clinical outcomes were at least as strong for online ratings as for traditional survey measures of patient experience.
  
  
  CONCLUSIONS
  Unsolicited web-based patient ratings of their care, though potentially prone to many biases, are correlated with survey measures of patient experience. They may be useful tools for patients when choosing healthcare providers and for clinicians to improve the quality of their services.
authors.affiliation: Department of Primary Care and Public Health, Reynolds Building, Charing Cross Campus, Imperial College London, London, UK. felix.greaves08@imperial.ac.uk
authors.forename: Felix
authors.initials: F
authors.lastname: Greaves
authors.forename: Utz J
authors.initials: UJ
authors.lastname: Pape
authors.forename: Dominic
authors.initials: D
authors.lastname: King
authors.forename: Ara
authors.initials: A
authors.lastname: Darzi
authors.forename: Azeem
authors.initials: A
authors.lastname: Majeed
authors.forename: Robert M
authors.initials: RM
authors.lastname: Wachter
authors.forename: Christopher
authors.initials: C
authors.lastname: Millett
mesh_terms: D002755:Choice Behavior; D003430:Cross-Sectional Studies; D003625:Data Collection / Q000379:methods*; D004739:England; D005260:Female; D019538:Health Care Surveys / Q000592:standards / Q000706:statistics & numerical data*; D006305:Health Status Indicators; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D020407:Internet / Q000592:standards / Q000706:statistics & numerical data*; D007400:Interprofessional Relations; D008297:Male; D009313:National Health Programs; D015279:Organizational Culture; D010351:Patient Discharge / Q000706:statistics & numerical data / Q000639:trends; D010359:Patient Readmission / Q000706:statistics & numerical data / Q000639:trends; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D028723:Personhood; D036301:Qualitative Research; D013222:State Medicine