Perceived Quality of Service in Primary Health Care Based on Google Maps Reviews Before, During, and After the COVID-19 Pandemic: Sentiment Analysis.

Background: The COVID-19 pandemic caused many changes in primary health care systems in Europe. The fast adoption of telemedicine, the shift of health care resources to COVID-19-related tasks, and the tendency of patients to cancel their nonurgent appointments are some examples of these changes. Patient satisfaction is an important outcome of health care services, and the changes caused by COVID-19 in the system may have affected it. Google Maps reviews provide an important channel for patients to communicate about their experiences regarding the primary health care system.

Objective: Drawing from research on social media data analytics and text mining, this study set out to investigate the changes in public sentiment regarding primary health care in Finland and Andalusia (Spain) before, during, and after the COVID-19 pandemic.

Methods: We collected 55,043 Google Maps reviews from primary health care locations in Finland and Andalusia from January 1, 2013, to May 15, 2024. There are 604 primary health care locations in Finland and 1016 in Andalusia. The total number of Google Maps reviews collected was 12,247 for Finland and 42,796 for Andalusia. First, lexicon-based sentiment analysis using the open-source software AFINN was conducted for the Finnish- and Spanish-language datasets. Thereafter, transformer-based deep learning models for sentiment analysis were applied for both languages. The numeric user ratings and the results of the sentiment analysis were then analyzed. In addition, we conducted a word frequency analysis of the reviews.

Results: There were important changes in the ratings and sentiment in the data for Andalusia. The ratings shifted from median 4 (IQR 3) before the COVID-19 pandemic to median 1 (IQR 2) during and median 1 (IQR 3) after the COVID-19 pandemic, on a scale from 1 to 5. The median of the sentiment values of the review texts shifted from neutral before the COVID-19 pandemic to -2 (IQR 0.055) or -1 (IQR 1) during and after the COVID-19 pandemic, depending on which sentiment analysis method was used. Interestingly, changes in numeric ratings and sentiment of the review texts in Finland were only minor, and the median values were the same during all 3 periods. Lexical analysis revealed changes in word frequencies across the periods, reflecting shifts in primary health care experiences during the pandemic, especially among the Spanish-language reviews.

Conclusions: The change toward a more negative public discussion on primary health care in Andalusia during the COVID-19 pandemic was considerable. This can be observed both in the numeric user ratings and in the sentiment analysis of the review texts. However, the data for Finland show that the public discourse stayed mostly neutral or slightly positive. The findings have implications on the quality management procedures in primary health care and on the use of user-generated content as an additional information source.