Properties of Healthcare Teaming Networks as a Function of Network Construction Algorithms

Network models of healthcare systems can be used to examine how providers collaborate, communicate, refer patients to each other. Most healthcare service network models have been constructed from patient claims data, using billing claims to link patients with providers. The data sets can be quite large, making standard methods for network construction computationally challenging and thus requiring the use of alternate construction algorithms. While these alternate methods have seen increasing use in generating healthcare networks, there is little to no literature comparing the differences in the structural properties of the generated networks. To address this issue, we compared the properties of healthcare networks constructed using different algorithms and the 2013 Medicare Part B outpatient claims data. Three different algorithms were compared: binning, sliding frame, and trace-route. Unipartite networks linking either providers or healthcare organizations by shared patients were built using each method. We found that each algorithm produced networks with substantially different topological properties. Provider networks adhered to a power law, and organization networks to a power law with exponential cutoff. Censoring networks to exclude edges with less than 11 shared patients, a common de-identification practice for healthcare network data, markedly reduced edge numbers and greatly altered measures of vertex prominence such as the betweenness centrality. We identified patterns in the distance patients travel between network providers, and most strikingly between providers in the Northeast United States and Florida. We conclude that the choice of network construction algorithm is critical for healthcare network analysis, and discuss the implications for selecting the algorithm best suited to the type of analysis to be performed.Comment: With links to comprehensive, high resolution figures and networks via figshare.co

Adoption and non-adoption of a shared electronic summary record in England: a mixed-method case study

Publisher version: http://www.bmj.com/content/340/bmj.c3111.full?sid=fcb22308-64fe-4070-9067-15a172b3aea

Making sense of tragedy: the ‘reputational’ antecedents of a hospital disaster

This article explores the workings of Reputational Dialogues (RD) (as a form of organizational discourse); within the setting of a UK NHS hospital that has encountered disaster. The disaster in question took place at the Bristol Royal Infirmary (BRI), circa 1984-1995; and is thought to have incurred the deaths of 34 ‘special heart babies’. The article explores patterns of RD utilization associated with the tragedy. Transcripts from the hearings of an inquiry into the disaster are used to access these patterns– if within specific limits and constraints that are discussed in the article. The article seeks to comment on the workings of RDs within the BRI disaster setting and considers, tentatively, how these dialogues may have helped to institutionalize dominant and (counter-cultural beliefs) about the BRI and its reputation as a provider of cardiovascular care to young children. Overall, the article contributes to organization theory by beginning the process of observing the institutionalization of RD and its by-products, as organizational phenomena

Promoting inclusion oral-health:social interventions to reduce oral health inequities

The aim of this collection of papers is to provide the reader with a cogent understanding of the role of evidence in the development of social or community-based interventions to promote inclusion oral-health and reduce oral health, health, and psychosocial inequities. In addition, this material will include various methods used for their implementation and evaluation. At the outset, the reader will be offered a working definition of inclusion oral-health, which will be modelled on the work of Luchenski et al. [1]. The interventions described are theoretically underpinned by a pluralistic definition of evidence-based practice [2] and the radical discourse of health promotion as postulated by Laverack and Labonte [3] and others [4,5]. This Special Issue will consist of eight papers, including an introduction. The first three papers will examine the various sources of evidence used to transform top-down into bottom-up community-based interventions for people experiencing homelessness; people in custody and for families residing in areas of high social deprivation. The final four papers will report on the implementation and evaluation of social or community-based interventions. This collection of research papers will highlight the importance of focusing on prevention and the adoption of a common risk factor agenda to tackle oral health, health and psychosocial inequities felt by those most excluded in our societies

Special Libraries, March 1968

Volume 59, Issue 3https://scholarworks.sjsu.edu/sla_sl_1968/1002/thumbnail.jp

Making sense of tragedy: the ‘reputational’ antecedents of a hospital disaster

This article explores the workings of Reputational Dialogues (RD) (as a form of organizational discourse); within the setting of a UK NHS hospital that has encountered disaster. The disaster in question took place at the Bristol Royal Infirmary (BRI), circa 1984-1995; and is thought to have incurred the deaths of 34 ‘special heart babies’. The article explores patterns of RD utilization associated with the tragedy. Transcripts from the hearings of an inquiry into the disaster are used to access these patterns– if within specific limits and constraints that are discussed in the article. The article seeks to comment on the workings of RDs within the BRI disaster setting and considers, tentatively, how these dialogues may have helped to institutionalize dominant and (counter-cultural beliefs) about the BRI and its reputation as a provider of cardiovascular care to young children. Overall, the article contributes to organization theory by beginning the process of observing the institutionalization of RD and its by-products, as organizational phenomena.Reputation effects; the medical profession; organizational crisis; institutionalization; discourse analysis

TB STIGMA – MEASUREMENT GUIDANCE

TB is the most deadly infectious disease in the world, and stigma continues to play a significant role in worsening the epidemic. Stigma and discrimination not only stop people from seeking care but also make it more difficult for those on treatment to continue, both of which make the disease more difficult to treat in the long-term and mean those infected are more likely to transmit the disease to those around them. TB Stigma – Measurement Guidance is a manual to help generate enough information about stigma issues to design and monitor and evaluate efforts to reduce TB stigma. It can help in planning TB stigma baseline measurements and monitoring trends to capture the outcomes of TB stigma reduction efforts. This manual is designed for health workers, professional or management staff, people who advocate for those with TB, and all who need to understand and respond to TB stigma