同行影响能解释处方的适当性吗? 一个社会网络分析分析
Sophie Y Wang1,2,3, Nicolas Larrain4,5, Oliver Groene6,7
1Hamburg Center for Health Economics, Esplanade 36, 20354, Hamburg, Germany. sophiey.wang@utoronto.ca.
BMC medical research methodology
|October 29, 2023
概括
医生网络连接影响处方性能. 网络边缘的实践与更好的信息访问显示出更好的处方,而高度连接的实践可能表现更差.
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
- 医疗实践管理 医疗实践管理
背景情况:
- 在老龄化人口中,多药制造成了相当大的成本.
- 医生社交网络影响了处方行为.
- 优化处方对患者的结果和医疗保健经济至关重要.
研究的目的:
- 分析医生实践网络连接和处方性能之间的关联.
- 研究医生之间的社会关系如何影响老年人的药物适宜性.
主要方法:
- 社交网络分析基于共享的患者绘制了医生实践的地图.
- 用FORTA算法测量了65岁以上患者不适当或错过的药物的处方性能.
- 负二项回归模型评估了网络中心性指标与规范性能之间的关系,控制共变量.
主要成果:
- 网络连接 (程度,间接性,自向量中心性) 与规定性能有显著的负相关性.
- 网络中心性较高的医生诊所表现出较差的处方结果.
- 敏感性分析证实了这些发现的可靠性.
结论:
- 医生实践处方表现与同行连接和网络位置有关.
- 网络外围的实践,有机会获得新的信息,证明了更好的处方.
- 在孤立网络中高度连接的实践与低于最佳的处方有关.
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