Measures of care fragmentation: Mathematical insights from population genetics.
Measures of care fragmentation: Mathematical insights from population genetics.
复制标题
护理碎片化的衡量标准：来自群体遗传学的数学见解。
DOI：
10.1111/1475-6773.13263
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发表时间：
2020
影响因子：
3.4
通讯作者：
Zulman,DonnaM
中科院分区：
文献类型：
--
作者：
Rosenberg,NoahA;Zulman,DonnaM
目的从遗传多样性的数学等价度量中发现卫生保健碎片化度量的新特性，研究设计我们描述了两个度量之间的数学关系：（a）Breslau的家庭护理提供者（UPC），最频繁访问的提供者的护理比例，类似于遗传位点上“最频繁等位基因的频率”;和（B）Bice-Boxerman护理连续性指数（COCI），一种跨多个提供者的护理分散度的测量，类似于遗传学中的“Nei纯合性估计”。最常访问的提供者（UPC）的护理比例为护理分散度（COCI）设置了下限和上限，反之亦然。该属性提出了归一化COCI给定UPC（NCGU）测量的可能性，其反映了取决于最频繁访问的提供者的访问次数的护理分散的有界范围。UPC和COCI的数学方面也建议阈值的最低数量的患者访问时使用的研究fragmentation. ConclusionsAppliing知识从人口遗传学阐明护理碎片化措施之间的关系，并产生新的见解护理碎片化研究。
ObjectiveTo identify novel properties of health care fragmentation measures, drawing on insights from mathematically equivalent measures of genetic diversity.Study DesignWe describe mathematical relationships between two measures: (a) Breslau's Usual Provider of Care (UPC), the proportion of care with the most frequently visited provider, analogous to the “frequency of the most frequent allele” at a genetic locus; and (b) Bice‐Boxerman's Continuity of Care Index (COCI), a measure of care dispersion across multiple providers, analogous to “Nei's estimator of homozygosity” in genetics.Principal FindingsJust as the frequency of the most frequent allele places a tight constraint on homozygosity, the proportion of care with the most frequently visited provider (UPC) places lower and upper bounds on dispersion of care (COCI), and vice versa. This property presents the possibility of a normalized COCI given UPC (NCGU) measure, which reflects a bounded range of care dispersion dependent on the number of visits with the most frequently visited provider. Mathematical aspects of UPC and COCI also suggest thresholds for the minimal number of patient visits to use when studying fragmentation.ConclusionsApplying knowledge from population genetics elucidated relationships between care fragmentation measures and produced novel insights for care fragmentation studies.