Scaling laws in healthcare delivery. A Network Analysis Approach to outpatient referral networks across the Veterans Health Administration.
Ben-Ari, A. Y.; Bigeleisen, P. E.; George, H. L.
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BACKGROUNDWe studied clinical referral networks across the Veterans Health Administration. Network attributes, referral counts and timeliness of services rendered were estimated and used to predict outpatient care performance. A scaling law for outpatient referrals was derived, predicting an economy of scale. METHODSNetwork topology and operational statistics were estimated and their relationships were studied. A comparative study of multiple networks was undertaken. RESULTSWe observed similarities both in network structure and in the referral patterns. These are invariant of the healthcare system size. A power scaling law for referrals was inferred with an infra-linear exponent. CONCLUSIONStudy of referral networks across multiple healthcare systems shows an economy of scale and self-similarity between network attributes that are patient size invariant.
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