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Who chooses, who uses, who rates: The impact of agency on electronic word-of-mouth about hospitals stays

Drevs, Florian; Hinz, Vera

doi: 10.1097/HMR.0b013e3182993b6a

Background: Patients’ agents rather than patients themselves often choose hospitals and rehabilitation centers and evaluate inpatient stays. Thus, online reviews of a hospital may reflect a service experience the patient is not responsible for in two ways. First, a patient may evaluate a hospital that a physician as agent has selected, although he still received the service and is qualified to evaluate it. Second, relatives who may not be directly involved in the inpatient stay may write online reviews, which reflect their own experiences and evaluations.

Purpose: The study analyzes patient satisfaction data in online hospitals reviews and patients’ underlying motives for electronic word-of-mouth according to the type of hospital admission and the perspective of the reviewer.

Methodology: The study uses a sample of 822 reviews from an online platform for hospital reviews and primary data generated by an online survey distributed to the writers of these reviews.

Findings: Patients who choose a hospital themselves write more positive online reviews than those with an other-directed choice. Relatives’ online reviews more often deal with negative hospital experiences and are more likely to reflect a desire for retaliation.

Practice Implications: The study results imply that medical care centers (hospitals and rehabilitation facilities) should pay more attention to agency by focusing on the needs and perceptions of relatives who often act as the critical voice of patients in electronic word-of-mouth behavior.

Florian Drevs, PhD, is Assistant Professor, Department of Marketing and Health Care Management, University of Freiburg, Germany. E-mail:

Vera Hinz, PhD, is Assistant Professor, Hamburg Center for Health Economics, University of Hamburg, Germany.

The authors confirmed that the work presented in this paper has been performed and interpreted solely by themselves and that all authors contributed equally and significantly to the paper. They have adhered to all editorial policies for submission as described in the Information for Authors.

The authors have disclosed that they have no significant relationship with, or financial interest in, any commercial companies pertaining to this article.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins