Density of Patient-Sharing Networks: Impact on the Value of Parkinson Care

A Scoping Review of Multilevel Patient-Sharing Network Measures in Health Services Research

Social network analysis is the study of the structure of relationships between social entities. Access to health care administrative datasets has facilitated use of "patient-sharing networks" to infer relationships between health care providers based on the extent to which they have encounters with common patients. The structure and nature of patient-sharing relationships can reflect observed or latent aspects of health care delivery systems, such as collaboration and influence. We conducted a scoping review of peer-reviewed studies that derived patient-sharing network measure(s) in the analyses. There were 134 papers included in the full-text review. We identified and created a centralized resource of 118 measures and uncovered three major themes captured by them: Influential and Key Players, Care Coordination and Teamwork, and Network Structure and Access to Care. Researchers may use this review to inform their use of patient-sharing network measures and to guide the development of novel measures.

Analysis of the patient-sharing network in hypertension management: a retrospective study in China

OBJECTIVE

To explore the robustness of the patient-sharing network and validate the association between strength and persistence of physicians' relationships in China.

DESIGN, SETTING AND PARTICIPANTS

We conducted a patient-sharing network analysis to describe the persistence of patient-sharing relationships and logistic regression to analyse factors associating with the persistence of patient-sharing relationships in the Yinzhou Health Information System from 1 January 2010 to 31 December 2018; all outpatient records that had a hypertension diagnosis were included in this study.

OUTCOME MEASURES

The persistence ratio was defined as the proportion of the patient-sharing relationships in a given year that continued to exist in the following year, the 1-, 2- and 3-year persistence to test the robustness of the findings.

RESULTS

This study included 3916 physicians from 42 public healthcare facilities in Yinzhou. The 1-year persistence ratio fluctuated around 80%, and the 3-year persistence ratio was around 60% over the study period. The strength of the relationship, tie characteristics and physician specialty were important factors associating with the persistence of the relationships. The persistence of the relationships increased significantly as the strength of the relationships increased (for relationships with strength ∈ [3, 5), OR=3.987, 95% CI 3.896 to 4.08; for relationships with strength ∈ [5, 7), OR=6.379, 95% CI 6.147 to 6.626; and for relationships with strength ∈ [7, 9), OR=8.373, 95% CI 7.941 to 8.829). Physicians from the same healthcare institution were more likely to form ties that persisted for at least 1 year compared with physicians from different institutions (OR=1.510, 95% CI 1.480 to 1.540).

CONCLUSIONS

Our study showed that physicians frequently formed relationships with other physicians through sharing patients in Yinzhou, China, and these relationships had similar rates of persistence to studies conducted in developed countries, which indicated that findings of social network analyses conducted in developed countries still hold value in developing countries.

Strengthening Communication and Collaboration in the Fragmented German Healthcare System: A Mixed-Method Evaluation of an Interdisciplinary Network for Parkinson's Disease

BACKGROUND

To improve Parkinson's disease (PD) care, interdisciplinary and patient-centered treatment is mandatory. A key problem in many healthcare systems is the limited and unspecific communication among different healthcare professionals. Optimal collaboration between various professionals involved is indispensable. Parkinson's Network Münsterland + (PNM +) is an interdisciplinary network of medical and non-medical experts involved in the treatment of PD patients in Germany.

OBJECTIVE

The aim of this evaluation was to analyze the network structures of PNM+ as well as communication and collaboration between PNM + partners.

METHODS

A mixed methods approach was applied consisting of a social network analysis, a validated questionnaire on team effectiveness and semi-structured interviews focusing on perceived barriers and supportive aspects of PNM + .

RESULTS

Quantitative and qualitative data suggested increased collaboration between professionals within PNM + . The reciprocity of connections was 0.522 in the network of professional contacts. Regular exchanges in terms of interdisciplinary panel meetings and working groups stimulated knowledge transfer, leading to greater specialization of general neurologists and therapists in PD. The progressive density of the network from 0.136 to 0.279 illustrates the growing cooperation of PNM + partners. Interviewed partners requested more patient-specific collaboration but expected this to happen as the network evolved. Overall, PNM + has already improved both diagnosis and therapy thanks to knowledge transfer. Structured treatment recommendations helped to improve communication between healthcare professionals.

CONCLUSION

PNM+ stimulated exchange between different healthcare professionals involved in the treatment of PD patients. This overcomes specific barriers within Germany's highly fragmented healthcare system, such as the lack of communication between these disciplines.