Inter-Agency Collaboration in the Care of Children with Complex Chronic Conditions
Inter-Agency Collaboration in the Care of Children with Complex Chronic Conditions
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DOI：
10.1016/j.acap.2012.02.007
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发表时间：
2012-05-01
影响因子：
3.1
通讯作者：
Easterling, Douglas
中科院分区：
文献类型：
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作者：
Nageswaran, Savithri;Ip, Edward H.;Easterling, Douglas
目的：这篇文章的目的是描述网络的合作机构，为儿童提供服务的复杂的慢性病（CCCs），并确定差距在network.METHODS：我们调查了代表机构，为儿童提供服务的CCCs在福赛斯县，北卡罗来纳州，他们的机构的现有和期望的合作与其他机构在网络中。我们使用社会网络分析（SNA）的方法来描述网络中的差距。平均出度和度的中心性（合作关系的数量延伸或指向一个机构）和密度（现存关系的比例，所有可能的关系）进行了measurement.Results：在这个网络与3658可能的合作关系，护理协调机构和儿科实践报告的最高现有的合作与其他机构（出度中心性：32和30，分别）。儿科实践报告与专科诊所（密度：73%）的紧密联系，但与家庭支持服务（密度：3%）的联系较弱。儿科实践和亚专科诊所（学位：26）从其他机构获得了最高的合作关系。支持服务和耐用医疗设备（DME）公司报告与其他机构的联系较低（分别为7和10）。护理机构报告的最高期望的合作（出度：18）。支持服务、儿科实践和护理协调项目在期望的合作中具有最高的中心度（分别为7、6和6）。护理机构和支持服务的差距最大的collaboration.CONCLUSION：虽然存在合作机构服务的儿童CCC之间，有很多差距的网络。未来的研究应探讨机构间合作的障碍和促进因素，以及网络中增加合作是否会改善患者水平的结果。
OBJECTIVES: The purpose of this article was to describe the network of collaboration among agencies that serve children with complex chronic conditions (CCCs) and identify gaps in the network.METHODS: We surveyed representatives from agencies that serve children with CCCs in Forsyth County, North Carolina, about their agencies' existing and desired collaborations with other agencies in the network. We used Social Network Analytical (SNA) methods to describe gaps in the network. Mean out-degree and in-degree centrality (number of collaborative ties extending from or directed toward an agency) and density (ratio of extant ties to all possible ties) were measured.RESULTS: In this network with 3658 possible collaborative ties, care-coordination agencies and pediatric practices reported the highest existing collaborations with other agencies (out-degree centrality: 32 and 30, respectively). Pediatric practices reported strong ties with subspecialty clinics (density: 73%), but weak ties with family support services (density: 3%). Pediatric practices and subspecialty clinics (in-degree: 26) received the highest collaborative ties from other agencies. Support services and durable medical equipment (DME) companies reported low ties with other agencies (out-degree: 7 and 10, respectively). Nursing agencies reported the highest desired collaborations (out-degree: 18). Support services, pediatric practices, and care-coordination programs had the highest in-degree centrality (7,6, and 6, respectively) for desired collaborations. Nursing agencies and support services had the greatest gaps in collaboration.CONCLUSION: Although collaboration exists among agencies serving children with CCCs, there are many gaps in the network. Future studies should explore barriers and facilitators to inter-agency collaborations and whether increased collaboration in the network improves patient-level outcomes.