A scoping review of patient-sharing network studies using administrative data

Abstract

There is a robust literature examining social networks and health, which draws on the network traditions in sociology and statistics. However, the application of social network approaches to understand the organization of health care is less well understood. The objective of this work was to examine approaches to conceptualizing, measuring, and analyzing provider patient-sharing networks. These networks are constructed using administrative data in which pairs of physicians are considered connected if they both deliver care to the same patient. A scoping review of English language peer-reviewed articles in PubMed and Embase was conducted from inception to June 2017. Two reviewers evaluated article eligibility based upon inclusion criteria and abstracted relevant data into a database. The literature search identified 10,855 titles, of which 63 full-text articles were examined. Nine additional papers identified by reviewing article references and authors were examined. Of the 49 papers that met criteria for study inclusion, 39 used a cross-sectional study design, 6 used a cohort design, and 4 were longitudinal. We found that studies most commonly theorized that networks reflected aspects of collaboration or coordination. Less commonly, studies drew on the strength of weak ties or diffusion of innovation frameworks. A total of 180 social network measures were used to describe the networks of individual providers, provider pairs and triads, the network as a whole, and patients. The literature on patient-sharing relationships between providers is marked by a diversity of measures and approaches. We highlight key considerations in network identification including the definition of network ties, setting geographic boundaries, and identifying clusters of providers, and discuss gaps for future study.

A Systematic Review of Network Studies Based on Administrative Health Data

“…We found 587 and 83 articles from PubMed and Scopus, respectively. We followed the steps described by DuGoff et al [12] in selecting the articles that were considered to review in this study. After removing 19 duplicate titles, we screened the remaining 424 articles.…”

The association between patient sharing network structure and healthcare costs

“…The identification of quantitative measures of the structural importance of a given physician (node) within a network has been extensively studied in network science. A number of such "centrality" measures, or how involved a given node is in the overall flow of the network, are commonly used, with a long literature related to the applications of these measures [7,11,26,27]. For example, the centrality of participants in a social network has been shown to be important in mediating what information is received from peers, and consequently what choices participants make [28].…”

“…Physician relationships measured via shared patients are associated with a large number of clinical and utilization outcomes [1][2][3][4][5][6][7][8][9][10][11][12]. These relationships, analyzed using social network measures, are a product of formal and informal information sharing [13,14], organizational affiliations [15,16], and care coordination [2,8].…”

A Framework to Understand the Progression of Cardiovascular Disease for Type 2 Diabetes Mellitus Patients Using a Network Approach

“…In the biomedical field, the network-based approach has been used to understand the pathogenesis of diseases using gene expression and related proteins [37]. Social network analysis (SNA) is another related approach introduced in healthcare informatics [38,39]. SNA can be defined as a set of entities, such as physicians, diseases and hospitals, with some relationships between them.…”