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Detecting Variation in Clinical Practice Patterns for Geriatric Trauma Care Using Social Network Analysis.
Molly P Jarman1,2, Mengyuan Ruan1, Masami Tabata-Kelly1,3
1Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA.
Annals of Surgery
|June 30, 2023
Summary
Physician professional networks vary by hospital and are linked to the proportion of older trauma patients treated. Denser, more cohesive networks correlate with higher geriatric trauma patient volumes, suggesting practice pattern differences.
Area of Science:
- Geriatric Trauma Care
- Health Services Research
- Social Network Analysis
Background:
- Hospital variation in geriatric trauma outcomes is poorly understood.
- Physician practice patterns, reflected in professional networks, may explain outcome disparities.
Purpose of the Study:
- To characterize hospital-level physician professional networks for older trauma patients.
- To examine the relationship between network characteristics and the proportion of geriatric trauma patients at a hospital.
Main Methods:
- Population-based, cross-sectional study (2014-2015) using Florida inpatient and Medicare data.
- Analyzed 107,713 older trauma patients and 169,282 patient-physician dyads from 158 hospitals.
- Employed social network analysis to assess network density, cohesion, small-worldness, and heterogeneity.
Main Results:
- Hospital geriatric trauma proportions ranged from 21.5% to 89.1%.
- Positive correlations found between network density, cohesion, small-worldness, and hospital geriatric trauma proportion.
- Negative correlation observed between network heterogeneity and geriatric trauma proportion.
Conclusions:
- Physician network characteristics are associated with the proportion of older trauma patients treated at a hospital.
- These associations suggest differing practice patterns across hospitals with varying geriatric trauma populations.
- Further research into interspecialty collaboration could improve treatment for injured older adults.
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