Analysis of the US patient referral network

被引:47
作者
An, Chuankai [1 ]
O'Malley, A. James [2 ,3 ]
Rockmore, Daniel N. [1 ,4 ]
Stock, Corey D. [4 ]
机构
[1] Dartmouth Coll, Dept Comp Sci, Hanover, NH 03755 USA
[2] Geisel Sch Med Dartmouth, Dept Biomed Data Sci, Lebanon, NH USA
[3] Geisel Sch Med Dartmouth, Dartmouth Inst Hlth Policy & Clin Practice, Lebanon, NH USA
[4] Dartmouth Coll, Dept Math, Hanover, NH 03755 USA
关键词
generative model; hierarchical modeling; network science; physician network; shared patient network; social network analysis; SHARING NETWORKS; PRIMARY-CARE; COLLABORATION; PHYSICIAN; QUALITY; DISTRIBUTIONS; DYNAMICS; COST;
D O I
10.1002/sim.7565
中图分类号
Q [生物科学];
学科分类号
090105 [作物生产系统与生态工程];
摘要
In this paper, we analyze the US Patient Referral Network (also called the Shared Patient Network) and various subnetworks for the years 2009 to 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 health care 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 health care system and opportunities or mechanisms for catalyzing improvements.
引用
收藏
页码:847 / 866
页数:20
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