What can we learn from looking at COVID-19 testing reviews?
More than ever before, the COVID-19 pandemic has served as a glaring reminder of the persistent inequities — those in the lowest-income brackets have seen the greatest rates of pandemic job losses while the richest five billionaires saw a “78 percent increase in their combined wealth during this period” (Inequality.org). Beyond the sheer magnitude of this economic unrest, COVID-19 has also highlighted the disparities in access to care and, notably, outcome disparities due to social determinants of health (the non-biological factors that influence an individual’s health outcomes).
At the heart of our research, we wanted to dig deeper to understand two fundamental research questions:
- What areas of the testing experience are most positively discussed? Negatively?
- How are people experiencing COVID-19 testing differently across the nation?
Our analysis highlights key areas of strength and opportunities for improvement in patients’ COVID-19 testing experience.
What Areas of the Testing Experience are Most Positively Discussed? Most Negatively Discussed?
Part 1) Most Positive: Staff and Patient Experience
Testing locations were most commonly praised for their “kind”, “attentive”, “courteous”, and “knowledgeable” staff. Undoubtedly, this was a comforting experience for many anxious patients who reported feeling “safe” and left beaming reviews of staff bedside manner, even leaving reviews thanking staff for their courage and heroism during these uncertain times.
Not only was a patient’s experience with staff the most commonly discussed categories, patients most highly praised a testing center for its staff efficiency, friendliness, and professionalism.
Most Negative: Results Turnaround Time
PCR COVID-19 test results were commonly delayed and many patients reported receiving results weeks after the 48-hour window that had been promised or not having received their results at all. Interestingly, these reviews have been consistently negative throughout the entirety of the pandemic. April through December reviews increasingly reported severely backlogged results consistent with the rapid increase in demand for COVID-19 testing that, by this time, had outpaced the supply of readily available COVID-19 testing reagents.
Our analysis found result turnaround speed as the most negatively reviewed aspect of testing centers. This was potentially associated with the shortages in lab supplies due to surges in testing demand.
How Are People Experiencing COVID-19 Testing Differently Across the Nation?
To examine how people are experiencing COVID19 testing differently across the nation, we analyzed our geolocated review data to assess the effect of income inequality on patient experiences. Utilizing publicly available income information from the US Census Bureau’s 2019 American Community Survey 1-year estimates, we grouped all reviews based on the national median household income level in inflation-adjusted dollars of $65,712: those who made over this median household income level (in green) and those who did not (in red).
Most interestingly, we see strong discrepancies between review sentiments relating to COVID-19 safety in testing centers in lower vs. higher earners. Although the data suggests an 11% lower sentiment in COVID-19 safety in lower-income levels, an examination into the reviews themselves tell an interesting story.
While both groups had reviews with information on unenforced mask-wearing, the reviews of centers located in lower-income areas contained more mentions of staff and patients explicitly not wearing masks or waiting rooms not adhering to social distancing guidelines. Additionally, while the reviews from higher-income areas showed more adherence to mask-wearing, there were also some instances of, particularly interesting reviews in our data. One review from one of the largest metro counties in Pennsylvania read “wear masks beware”, reflecting an aversion to mask-wearing. However, reviews from similarly sized counties in Texas and Florida more commonly reflected dissatisfaction as a result of others improperly wearing masks.
This is a finding of particular importance as mask-wearing was officially recommended by the CDC and the White House Coronavirus Task Force as of April 3rd, 2020. All of our analyzed reviews on COVID-19 safety at testing facilities were written in the months of June through December. By the first COVID-19 safety review in our dataset, the pandemic had already reached its first peak in many areas of the country and mask-wearing recommendations had been in effect for roughly 2 months. The lack of adherence to and implementation of COVID safety procedures is particularly concerning as COVID19 safety procedures must be strictly followed to work effectively and to contain the spread.
Overall, from our analysis, we generally see lower levels of satisfaction amongst the bottom 50% of earners than the top 50% of earners.
Takeaways
From our analysis, we can see that a patient’s interactions with the testing center staff were still most important to the overall patient experience. In general, staff’s ability to quell uncertainty, act swiftly, and provide needed support is top of mind for the majority of patients and the delay in returning results continues to be a pain point for many testing facilities.
There is a disparity between average sentiments in the top and bottom 50% of earners in the United States. Individuals in areas under the median national household income level were more likely to report being dissatisfied with a location’s lack of adherence to or enforcement of COVID safety measures, such as social distancing and proper mask-wearing.
Additionally, the discrepancies in COVID-19 safety procedures in testing facilities creates an additional hurdle as our healthcare systems struggle to keep up with the increasing number of cases. While material hurdles like slow turnaround times can be mitigated with more resources and supplies, immaterial problems identified by our analysis, such as lack of adherence to and implementation of COVID-19 safety procedures are much more difficult to address. In all testing locations, staff should continue to act with compassion and exceptional professionalism while staying vigilant in enforcing proper mask-wearing and social distancing while patients wait for testing appointments.
