Understanding health system operation using networks: A literature review

Abstract

Network analysis has been identified as an important approach for understanding and improving large scale health system operations. This review sought to understand the existing ways in which network analysis has been applied to health system operations by assessing; the topic areas, entity interaction types, network metrics used to describe system operations, the real world correlates of those network metrics and appraise the current and future trends in this area.The review included 52 articles identified using a snowball sampling method. Theanalysis showed that ’Care coordination’ was the most common topic topic area. The networks were most often constructed using patient level data describing care collaboration, patient transfers, physician collaboration and patient referrals. Measures of connectedness were most often applied such as density, centrality measures and degree. These measures were used to describe collaboration between clinicians and organisations, assess resource requirements and assess how patients were moving through the health system.The majority of the studies reported in the literature present descriptive studies of health system operations. Future work in this area should focus on using network analysis for predictive purposes e.g. forecasting and simulation parameterisation. There is also great potential in the use of dynamic network analysis to assess trendsin system operations over time.