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
