Analysis of the U.S. patient referral network.

Analysis of the U.S. patient referral network.
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DOI:
10.1002/sim.7565
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发表时间:
2018-02-28
影响因子:
2
通讯作者:
Stock CD
Stock CD
中科院分区:
医学3区
文献类型:
--
作者:
An C;O'Malley AJ;Rockmore DN;Stock CD

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在本文中,我们分析了 2009-2015 年美国患者转诊网络(也称为共享患者网络)和各种子网络。根据医疗保险和医疗补助服务中心提供的数据,在这些网络中,如果患者在指定的时间间隔内遇到两位医生,就会将两位医生联系起来。我们在大多数州级数据上发现了幂律分布以及核心-外围结构。在国家和州的层面上,我们发现了所谓的小世界结构以及一些大型经济网络中存在的“引力定律”。一些医生发挥着州际转诊中心的作用。某些网络统计数据与州和国家层面的医疗保健系统统计数据之间存在很强的相关性。使用涉及从网络导出的关键指标的多项统计分析显示的转诊网络中的模式说明了使用网络分析提供对医疗保健系统的新见解以及促进改进的机会或机制的潜力。
In this paper we analyze the US Patient Referral Network (also called the Shared Patient Network) and various subnetworks for the years 2009–2015. In these networks two physicians are linked if a patient encounters both of them within a specified time-interval, according to the data made available by the Centers for Medicare and Medicaid Services. We find power law distributions on most state-level data as well as a core-periphery structure. On a national and state level, we discover a so-called small-world structure as well as a “gravity law" of the type found in some large-scale economic networks. Some physicians play the role of hubs for interstate referral. Strong correlations between certain network statistics with healthcare system statistics at both the state and national levels are discovered. The patterns in the referral network evinced using several statistical analyses involving key metrics derived from the network illustrate the potential for using network analysis to provide new insights into the healthcare system and opportunities or mechanisms for catalyzing improvements.
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