美国各地医生患者共享网络的变化
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
概括
医生专业网络因地理区域而异. 连接的医生具有相似的患者人口统计数据,更有可能在同一家医院执业.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 社交网络分析 社交网络分析
- 医学社会学 医学社会学
背景情况:
- 医生在非正式的专业网络中工作,这些网络是由共享的患者,信息和实践所塑造的.
- 了解这些网络对于分析医疗保健和医生行为至关重要.
研究的目的:
- 识别和描述不同地理区域的医生专业网络.
- 检查网络结构的变化,并确定影响医生连接的因素.
主要方法:
- 从2006年起使用社会网络分析技术对Medicare行政数据进行分析.
- 研究了51个医院转诊区域 (HRR) 的68,288名医生和4,586,044名医疗保险受益人.
- 在每个HRR中建立医生网络,基于每个HRR的共享患者遭遇.
主要成果:
- 在HRR中观察到的网络特征的显著变化,包括医生中心性和网络密度.
- 连接的医生更有可能与同一医院 (96.0%与69.2%) 相关联,并且在更接近的地理位置 (21.1公里与38.7公里) 实践.
- 与连接网络的医生相比,与未连接网络的医生相比,在种族和疾病负担方面,连接网络的医生表现出更相似的患者小组.
结论:
- 医生网络结构和特征在不同地理市场之间存在很大差异.
- 医生倾向于与具有相似实践特征和患者小组属性的同行建立联系.
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