Care coordination in epilepsy: Measuring neurologists' connectivity using social network analysis

Hamada Hamid Altalib, Brenda T. Fenton, Kei Hoi Cheung, Mary Jo V. Pugh, Jonathan Bates, Thomas W. Valente, Robert D. Kerns, Cynthia A. Brandt

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Objective The study sought to quantify coordination of epilepsy care, over time, between neurologists and other health care providers using social network analysis (SNA). Methods The Veterans Health Administration (VA) instituted an Epilepsy Center of Excellence (ECOE) model in 2008 to enhance care coordination between neurologists and other health care providers. Provider networks in the 16 VA ECOE facilities (hub sites) were compared to a subset of 33 VA facilities formally affiliated (consortium sites) and 14 unaffiliated VA facilities. The number of connections between neurologists and each provider (node degree) was measured by shared epilepsy patients and tallied to generate estimates at the facility level separately within and across facilities. Mixed models were used to compare change of facility-level node degree over time across the three facility types, adjusted for number of providers per facility. Results Over the time period 2000–2013, epilepsy care coordination both within and across facilities significantly increased. These increases were seen in all three types of facilities namely hub, consortium, and unaffiliated site, relatively equally. The increase in connectivity was more dramatic with providers across facilities compared to providers within the same facilities. Conclusion Establishment of the ECOE hub and spoke model contributed to an increase in epilepsy care coordination both within and across facilities from 2000 to 2013, but there was substantial variation across different facilities. SNA is a tool that may help measure coordination of specialty care.

Original languageEnglish (US)
Pages (from-to)31-35
Number of pages5
JournalEpilepsy and Behavior
Volume73
DOIs
StatePublished - Aug 2017

Keywords

  • Coordination of care
  • Epilepsy
  • Health services
  • Social network analysis

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Behavioral Neuroscience

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    Altalib, H. H., Fenton, B. T., Cheung, K. H., Pugh, M. J. V., Bates, J., Valente, T. W., Kerns, R. D., & Brandt, C. A. (2017). Care coordination in epilepsy: Measuring neurologists' connectivity using social network analysis. Epilepsy and Behavior, 73, 31-35. https://doi.org/10.1016/j.yebeh.2017.05.026