Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
PLoS One. 2011;6(12):e29342. doi: 10.1371/journal.pone.0029342. Epub 2011 Dec 27.
Acute care facilities are connected via patient sharing, forming a network. However, patient sharing extends beyond this immediate network to include sharing with long-term care facilities. The extent of long-term care facility patient sharing on the acute care facility network is unknown. The objective of this study was to characterize and determine the extent and pattern of patient transfers to, from, and between long-term care facilities on the network of acute care facilities in a large metropolitan county.
METHODS/PRINCIPAL FINDINGS: We applied social network constructs principles, measures, and frameworks to all 2007 annual adult and pediatric patient transfers among the healthcare facilities in Orange County, California, using data from surveys and several datasets. We evaluated general network and centrality measures as well as individual ego measures and further constructed sociograms. Our results show that over the course of a year, 66 of 72 long-term care facilities directly sent and 67 directly received patients from other long-term care facilities. Long-term care facilities added 1,524 ties between the acute care facilities when ties represented at least one patient transfer. Geodesic distance did not closely correlate with the geographic distance among facilities.
CONCLUSIONS/SIGNIFICANCE: This study demonstrates the extent to which long-term care facilities are connected to the acute care facility patient sharing network. Many long-term care facilities were connected by patient transfers and further added many connections to the acute care facility network. This suggests that policy-makers and health officials should account for patient sharing with and among long-term care facilities as well as those among acute care facilities when evaluating policies and interventions.
急症护理机构通过患者共享相互连接，形成网络。然而，患者共享不仅限于此直接网络，还包括与长期护理机构的共享。长期护理机构在急症护理机构网络上的患者共享程度尚不清楚。本研究的目的是描述和确定在一个大型都会县的急症护理机构网络上，长期护理机构与急症护理机构之间、向急症护理机构和从急症护理机构转来的患者的数量、模式和程度。
方法/主要发现：我们应用社会网络构建原则、方法和框架，使用加利福尼亚州奥兰治县医疗保健机构 2007 年所有成人和儿科患者的转移数据（来自调查和多个数据集），对网络中的所有患者转移进行了分析。我们评估了一般网络和中心性度量以及个体自我度量，并进一步构建了社交图。我们的结果表明，在一年的时间里，72 家长期护理机构中有 66 家直接向其他长期护理机构发送患者，67 家直接从其他长期护理机构接收患者。当关系至少代表一次患者转移时，长期护理机构在急症护理机构之间增加了 1524 条关系。测地线距离与设施之间的地理距离并不密切相关。
结论/意义：本研究表明了长期护理机构与急症护理机构患者共享网络的连接程度。许多长期护理机构通过患者转移相互连接，并进一步为急症护理机构网络增加了许多连接。这表明政策制定者和卫生官员在评估政策和干预措施时，应考虑到与长期护理机构以及急症护理机构之间的患者共享情况。
