Effect of hospital referral networks on patient readmissions

TY - JOUR

T1 - Effect of hospital referral networks on patient readmissions

AU - Mascia, Daniele

AU - Angeli, Federica

AU - Di Vincenzo, Fausto

PY - 2015/5/1

Y1 - 2015/5/1

N2 - Previous studies have shown that referral networks encompass important mechanisms of coordination and integration among hospitals, which enhance numerous organizational-level benefits, such as productivity, efficiency, and quality of care. The present study advances previous research by demonstrating how hospital referral networks influence patient readmissions. Data include 360,697 hospitalization events within a regional community of hospitals in the Italian National Health Service. Multilevel hierarchical regression analysis tests the impacts of referral networks' structural characteristics on patient hospital readmissions. The results demonstrate that organizational centrality in the overall referral network and ego-network density have opposing effects on the likelihood of readmission events within hospitals; greater centrality is negatively associated with readmissions, whereas greater ego-network density increases the likelihood of readmission events. Our findings support the (re)organization of healthcare systems and provide important indications for policymakers and practitioners.

AB - Previous studies have shown that referral networks encompass important mechanisms of coordination and integration among hospitals, which enhance numerous organizational-level benefits, such as productivity, efficiency, and quality of care. The present study advances previous research by demonstrating how hospital referral networks influence patient readmissions. Data include 360,697 hospitalization events within a regional community of hospitals in the Italian National Health Service. Multilevel hierarchical regression analysis tests the impacts of referral networks' structural characteristics on patient hospital readmissions. The results demonstrate that organizational centrality in the overall referral network and ego-network density have opposing effects on the likelihood of readmission events within hospitals; greater centrality is negatively associated with readmissions, whereas greater ego-network density increases the likelihood of readmission events. Our findings support the (re)organization of healthcare systems and provide important indications for policymakers and practitioners.

KW - Hierarchical linear modeling

KW - Interorganizational collaboration

KW - Patient readmission

KW - Social network analysis

UR - http://www.scopus.com/inward/record.url?scp=84924989346&partnerID=8YFLogxK

U2 - 10.1016/j.socscimed.2015.03.029

DO - 10.1016/j.socscimed.2015.03.029

M3 - Article

C2 - 25795994

AN - SCOPUS:84924989346

SN - 0277-9536

VL - 132

SP - 113

EP - 121

JO - Social science and medicine

JF - Social science and medicine

ER -