Journal of medical Internet research
Alternate Journal
J. Med. Internet Res.

BACKGROUND: Racial and ethnic minority groups often face worse patient experiences compared with the general population, which is directly related to poorer health outcomes within these minority populations. Evaluation of patient experience among racial and ethnic minority groups has been difficult due to lack of representation in traditional health care surveys.

OBJECTIVE: This study aims to assess the feasibility of Twitter for identifying racial and ethnic disparities in patient experience across the United States from 2013 to 2016.

METHODS: In total, 851,973 patient experience tweets with geographic location information from the United States were collected from 2013 to 2016. Patient experience tweets included discussions related to care received in a hospital, urgent care, or any other health institution. Ordinary least squares multiple regression was used to model patient experience sentiment and racial and ethnic groups over the 2013 to 2016 period and in relation to the implementation of the Patient Protection and Affordable Care Act (ACA) in 2014.

RESULTS: Racial and ethnic distribution of users on Twitter was highly correlated with population estimates from the United States Census Bureau's 5-year survey from 2016 (r=0.99; P<.001 from="" to="" the="" average="" patient="" experience="" sentiment="" was="" highest="" for="" white="" patients="" followed="" by="" asian="" islander="" hispanic="" and="" american="" indian="" native="" patients.="" a="" reduction="" in="" negative="" on="" twitter="" all="" racial="" ethnic="" groups="" seen="" users="" who="" identified="" as="" showed="" greatest="" improvement="" with="" times="" greater="" increase="" than="" white.="" black="" had="" postimplementation="" of="" aca="" compared="" preimplementation="" this="" change="">

CONCLUSIONS: The ACA mandated the implementation of the measurement of patient experience of care delivery. Considering that quality assessment of care is required, Twitter may offer the ability to monitor patient experiences across diverse racial and ethnic groups and inform the evaluation of health policies like the ACA.

Hswen Y, Hawkins JB, Sewalk K, Tuli G, Williams DR, Viswanath K, Subramanian S, Brownstein JS. Racial and Ethnic Disparities in Patient Experiences in the United States: 4-Year Content Analysis of Twitter. Journal of medical Internet research. 2020;22(8):e17048. doi:10.2196/17048.