Relation of the Networks Formed by Diabetic Patients Sharing Physicians With Emergency Department Visits and Hospitalizations
Bibliographic Data
| ID | 9100995 |
|---|---|
| Authors | James W Davis (0000-0002-8137-0323, University of Hawaiʻi at Mānoa, corresponding author), James Davis (0000-0003-1034-2998, John A. Burns School of Medicine, Honolulu), E Lim (0000-0002-3056-1269, University of Hawaiʻi at Mānoa, corresponding author), Deborah A Taira (0000-0002-1989-0109, Daniel K. Inouye College of Pharmacy, Hilo, HI), John Chen (0000-0003-0453-3085, John A. Burns School of Medicine, Honolulu, corresponding author) |
| Year | 2020 |
| Volume | 58 |
| Issue | 9 |
| Pages | 800-804 |
| Publication date | 2020-09-01 |
| Peer Reviewed | Yes |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/mlr.0000000000001378 |
| PMID | 32826745 |
| OpenAlex | W3080116318 |
| Language | EN |
| References cited | 19 |
OBJECTIVE: The objective of this study was to evaluate if the networks of diabetic patients sharing physicians are associated with emergency department (ED) visits and hospitalizations. STUDY DESIGN: This is a retrospective cohort study. METHODS: We used administrative data from a large insurer in Hawaii in 2010. Three types of networks were defined based on patient visits: (1) the total number of links from one patient to other patients sharing a physician; (2) the number of other patients connected by sharing the physician seen the most often; and (3) the number of other patients connected by seeing all the same physicians during the year. The networks were characterized into thirds based on their complexity and analyzed using zero-inflated negative binomial regression models on ED visits and hospitalizations. RESULTS: The study included 38,767 diabetes patients with a mean age of 64 years. Patients sharing the most physicians had double the risks of ED visits and hospitalizations. Patients linked by belonging to the largest primary care practices had a 28% reduced odds of ED visits. Patients linked by seeing all of the same physicians during the year had the fewest primary care providers and specialists visits and 25%-50% reductions in ED visits and hospitalizations. CONCLUSIONS: Networks of diabetic patients sharing all the same physicians were associated with decreased ED visits and hospitalizations. Encouraging diabetic patients to find a provider they like and trust and to stay in the provider's care may help reduce the risks of adverse events. Physicians building loyalty among their patients may reduce their patients' risks
Cohort · Diabetes mellitus · Emergency department · Family medicine · Logistic regression · Medical emergency · Odds · Odds ratio · Primary care · Retrospective cohort study · Emergency Medicine · Healthcare Policy and Management · Healthcare Systems and Technology · Internal Medicine · Medicine · Nursing · Primary Care and Health Outcomes
| Citation velocity | historical |
|---|---|
| Highly cited | No |