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Background The quality of care in labor and delivery is traditionally measured through the Hospital Consumer Assessment of Healthcare Providers and Systems but less is known about the experiences of care reported by patients and caregivers on online sites that are more easily accessed by the public. Objective The aim of this study was to generate insight into the labor and delivery experience using hospital reviews on Yelp. Methods We identified all Yelp reviews of US hospitals posted online from May 2005 to March 2017. We used a machine learning tool, latent Dirichlet allocation, to identify 100 topics or themes within these reviews and used Pearson r to identify statistically significant correlations between topics and high (5-star) and low (1-star) ratings. Results A total of 1569 hospitals listed in the American Hospital Association directory had at least one Yelp posting, contributing a total of 41,095 Yelp reviews. Among those hospitals, 919 (59%) had at least one Yelp rating for labor and delivery services (median of 9 reviews), contributing a total of 6523 labor and delivery reviews. Reviews concentrated among 5-star (n=2643, 41%) and 1-star reviews (n=1934, 30%). Themes strongly associated with favorable ratings included the following: top-notch care (r=0.45, P Conclusions Online review content about labor and delivery can provide meaningful information about patient satisfaction and experiences. Narratives from these reviews that are not otherwise captured in traditional surveys can direct efforts to improve the experience of obstetrical care.

BACKGROUND The quality of care in labor and delivery is traditionally measured through the Hospital Consumer Assessment of Healthcare Providers and Systems but less is known about the experiences of care reported by patients and caregivers on online sites that are more easily accessed by the public. OBJECTIVE The aim of this study was to generate insight into the labor and delivery experience using hospital reviews on Yelp. METHODS We identified all Yelp reviews of US hospitals posted online from May 2005 to March 2017. We used a machine learning tool, latent Dirichlet allocation, to identify 100 topics or themes within these reviews and used Pearson r to identify statistically significant correlations between topics and high (5-star) and low (1-star) ratings. RESULTS A total of 1569 hospitals listed in the American Hospital Association directory had at least one Yelp posting, contributing a total of 41,095 Yelp reviews. Among those hospitals, 919 (59%) had at least one Yelp rating for labor and delivery services (median of 9 reviews), contributing a total of 6523 labor and delivery reviews. Reviews concentrated among 5-star (n=2643, 41%) and 1-star reviews (n=1934, 30%). Themes strongly associated with favorable ratings included the following: top-notch care (r=0.45, Pr=0.52, Pr=0.46, Pr=0.44, Pr=0.38, Pr=0.30, Pr=0.47, Pr=0.32, P CONCLUSIONS Online review content about labor and delivery can provide meaningful information about patient satisfaction and experiences. Narratives from these reviews that are not otherwise captured in traditional surveys can direct efforts to improve the experience of obstetrical care.

The public health status of the United States is in a critical state. Rates of overweight and obese children are on the rise in nearly every community in the nation, and obesity is quickly becoming a global problem as well. While there are many biological, cultural, and psychological factors that play into the rising rates, social factors as a cause of decreasing health are often overlooked. The “built environment,” or each community’s living, working, and eating spaces, plays a large role in determining the actions taken by individuals in a community. In this study, the built environments of two socioeconomically different neighborhoods in Nashville, Tennessee, are analyzed. The resulting data is compared to Tennessee state health census reports to posit that a decreased quality of food and physical activity related built environments parallels a rise in chronic health problems.