https://scholars.lib.ntu.edu.tw/handle/123456789/631075
標題: | Social network analysis of nationwide interhospital emergency department transfers in Taiwan | 作者: | CHU-LIN TSAI MING-TAI CHENG SHU-HSIEN HSU TSUNG-CHIEN LU CHIEN-HUA HUANG Liu, Yueh-Ping Shih, Chung-Liang CHENG-CHUNG FANG |
公開日期: | 9-二月-2023 | 卷: | 13 | 期: | 1 | 來源出版物: | Scientific reports | 摘要: | Transferring patients between emergency departments (EDs) is a complex but important issue in emergency care regionalization. Social network analysis (SNA) is well-suited to characterize the ED transfer pattern. We aimed to unravel the underlying transfer network structure and to identify key network metrics for monitoring network functions. This was a retrospective cohort study using the National Electronic Referral System (NERS) database in Taiwan. All interhospital ED transfers from 2014 to 2016 were included and transfer characteristics were retrieved. Descriptive statistics and social network analysis were used to analyze the data. There were a total of 218,760 ED transfers during the 3-year study period. In the network analysis, there were a total of 199 EDs with 9516 transfer ties between EDs. The network demonstrated a multiple hub-and-spoke, regionalized pattern, with low global density (0.24), moderate centralization (0.57), and moderately high clustering of EDs (0.63). At the ED level, most transfers were one-way, with low reciprocity (0.21). Sending hospitals had a median of 5 transfer-out partners [interquartile range (IQR) 3-7), while receiving hospitals a median of 2 (IQR 1-6) transfer-in partners. A total of 16 receiving hospitals, all of which were designated base or co-base hospitals, had 15 or more transfer-in partners. Social network analysis of transfer patterns between hospitals confirmed that the network structure largely aligned with the planned regionalized transfer network in Taiwan. Understanding the network metrics helps track the structure and process aspects of regionalized care. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/631075 | ISSN: | 2045-2322 | DOI: | 10.1038/s41598-023-29554-4 |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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