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. 2011;6(12):e29342.
doi: 10.1371/journal.pone.0029342. Epub 2011 Dec 27.

Long-term care facilities: important participants of the acute care facility social network?

Bruce Y Lee  1 , Yeohan Song, Sarah M Bartsch, Diane S Kim, Ashima Singh, Taliser R Avery, Shawn T Brown, S Levent Yilmaz, Kim F Wong, Margaret A Potter, Donald S Burke, Richard Platt, Susan S Huang
Affiliations

Long-term care facilities: important participants of the acute care facility social network?

Bruce Y Lee et al. PLoS One. 2011.

Abstract

Background: 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.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Sociograms of Orange County Healthcare Facility Network at Two Patient Sharing Thresholds.
A) Long-term Acute Care Facility (LTCF) Network. B) Acute Care Facility Network. C) All Facilities.
Figure 2
Figure 2. Acute Care Facility Ego Networks at the ≥10 Patient Sharing Threshold.
A) Relatively Isolated Facility. B) Sparsely Connected Facility. C) Moderately Connected Facility. D) Extensively Connected Facility.
See this image and copyright information in PMC

References

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    1. Lee BY, McGlone SM, Song Y, Avery TR, Eubank S, et al. Social network analysis of patient sharing among hospitals in Orange County, California. Am J Public Health. 2011;101:707–713. - PMC - PubMed
    1. Lee BY, McGlone SM, Wong KF, Yilmaz SL, Avery TR, et al. Modeling the Spread of Methicillin-Resistant Staphylococcus aureus (MRSA) Outbreaks throughout the Hospitals in Orange County, California. Infect Control Hosp Epidemiol. 2011;32:562–572. - PMC - PubMed
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    1. Centers for Medicare and Medicaid Services. Minimum Data Set. Baltimore, MD: U.S. Department of Health and Human Services. Sacramento, CA; 2007.

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