米国全土の医師の患者共有ネットワークの変動
Bruce E Landon1, Nancy L Keating, Michael L Barnett
1Department of Health Care Policy, School of Medicine, Harvard University, Cambridge, Massachusetts, USA. landon@hcp.med.harvard.edu
JAMA
|July 17, 2012
まとめ
医者の専門ネットワークは,地理的地域によって大きく異なります. コネクテッドの医師は,同様の患者の人口統計を共有し,同じ病院で診療を行う可能性が高くなります.
科学分野:
- 医療サービス 研究 医療サービス
- ソーシャルネットワーク 分析 分析
- 医学社会学 医学社会学
背景:
- 医者は,共有された患者,情報,実践によって形成された非公式の専門ネットワークの中で活動しています.
- これらのネットワークを理解することは,医療の提供と医師の行動の分析に不可欠です.
研究 の 目的:
- 異なる地理的地域における医師のプロフェッショナル・ネットワークを特定し,特徴づけること.
- ネットワーク構造の変異を調査し,医師の接続に影響を与える要因を特定します.
主な方法:
- 2006年以降のメディケア行政データに関するソーシャルネットワーク分析技術を採用した.
- 51の病院紹介地域 (HRR) で68,288人の医師と4,586,044人のメディケア受給者を研究しました.
- 各HRR内の患者との出会いを共有した医師ネットワークを構築.
主要な成果:
- 医者の中心性とネットワーク密度を含むHRR全体で観測されたネットワーク特性の有意な変動.
- 接続された医師は,同じ病院 (96.0% vs. 69.2%) に所属し,より近い地理的距離 (21.1 km vs. 38.7 km) で診療を行う可能性が高くなりました.
- 接続されたネットワークの医師は,接続されていない医師と比較して,人種と病気の負担に関して,より類似した患者パネルを示しました.
結論:
- 医者のネットワークの構造と特徴は,地理的な市場によって大きく異なります.
- 医師は,同様の実践の特徴と患者パネル属性を共有する同僚とつながりを形成する傾向があります.
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