title: A cross-sectional study assessing the association between online ratings and structural and quality of care measures: results from two German physician rating websites.
abstract: BACKGROUND
  Even though physician rating websites (PRWs) have been gaining in importance in both practice and research, little evidence is available on the association of patients' online ratings with the quality of care of physicians. It thus remains unclear whether patients should rely on these ratings when selecting a physician. The objective of this study was to measure the association between online ratings and structural and quality of care measures for 65 physician practices from the German Integrated Health Care Network "Quality and Efficiency" (QuE).
  
  
  METHODS
  Online reviews from two German PRWs were included which covered a three-year period (2011 to 2013) and included 1179 and 991 ratings, respectively. Information for 65 QuE practices was obtained for the year 2012 and included 21 measures related to structural information (N = 6), process quality (N = 10), intermediate outcomes (N = 2), patient satisfaction (N = 1), and costs (N = 2). The Spearman rank coefficient of correlation was applied to measure the association between ratings and practice-related information.
  
  
  RESULTS
  Patient satisfaction results from offline surveys and the patients per doctor ratio in a practice were shown to be significantly associated with online ratings on both PRWs. For one PRW, additional significant associations could be shown between online ratings and cost-related measures for medication, preventative examinations, and one diabetes type 2-related intermediate outcome measure. There again, results from the second PRW showed significant associations with the age of the physicians and the number of patients per practice, four process-related quality measures for diabetes type 2 and asthma, and one cost-related measure for medication.
  
  
  CONCLUSIONS
  Several significant associations were found which varied between the PRWs. Patients interested in the satisfaction of other patients with a physician might select a physician on the basis of online ratings. Even though our results indicate associations with some diabetes and asthma measures, but not with coronary heart disease measures, there is still insufficient evidence to draw strong conclusions. The limited number of practices in our study may have weakened our findings.
authors.affiliation: Friedrich-Alexander-University Erlangen-Nuremberg, School of Business and Economics, Institute of Management (IFM), Lange Gasse 20, 90403, Nuremberg, Germany. martin.emmert@fau.de.
authors.forename: Martin
authors.initials: M
authors.lastname: Emmert
authors.affiliation: Chair of Health Management, Friedrich-Alexander-University Erlangen-Nuremberg, School of Business and Economics, Institute of Management (IFM), Lange Gasse 20, 90403, Nuremberg, Germany. thomas.adelhardt@fau.de.
authors.forename: Thomas
authors.initials: T
authors.lastname: Adelhardt
authors.affiliation: University of Applied Sciences and Arts, Hannover, Germany. Uwe.Sander@hs-hannover.de.
authors.forename: Uwe
authors.initials: U
authors.lastname: Sander
authors.affiliation: Integrated Healthcare Network "Quality and Efficiency" (QuE eG), Nuremberg, Vogelsgarten 1, 90402, Nuremberg, Germany. info@drwambach.de.
authors.forename: Veit
authors.initials: V
authors.lastname: Wambach
authors.affiliation: Integrated Healthcare Network "Quality and Efficiency" (QuE eG), Nuremberg, Vogelsgarten 1, 90402, Nuremberg, Germany. Joerg.Lindenthal@que-nuernberg.de.
authors.forename: Jörg
authors.initials: J
authors.lastname: Lindenthal
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010820:Physicians / Q000592:standards*; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care; D011795:Surveys and Questionnaires