Falster, M. O., Jorm, L. R. and Leyland, A. H. (2018) Using weighted hospital service area networks to explore variation in preventable hospitalization. Health Services Research, 53(S1), pp. 3148-3169. (doi: 10.1111/1475-6773.12777) (PMID:28940236) (PMCID:PMC6056604)
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Abstract
Objective: To demonstrate the use of multiple-membership multilevel models, which analytically structure patients in a weighted network of hospitals, for exploring between-hospital variation in preventable hospitalizations. Data Sources: Cohort of 267,014 people aged over 45 in NSW, Australia. Study Design: Patterns of patient flow were used to create weighted hospital service area networks (weighted-HSANs) to 79 large public hospitals of admission. Multiple-membership multilevel models on rates of preventable hospitalization, modeling participants structured within weighted-HSANs, were contrasted with models clustering on 72 hospital service areas (HSAs) that assigned participants to a discrete geographic region. Data Collection/Extraction Methods: Linked survey and hospital admission data. Principal Findings: Between-hospital variation in rates of preventable hospitalization was more than two times greater when modeled using weighted-HSANs rather than HSAs. Use of weighted-HSANs permitted identification of small hospitals with particularly high rates of admission and influenced performance ranking of hospitals, particularly those with a broadly distributed patient base. There was no significant association with hospital bed occupancy. Conclusion: Multiple-membership multilevel models can analytically capture information lost on patient attribution when creating discrete health care catchments. Weighted-HSANs have broad potential application in health services research and can be used across methods for creating patient catchments.
| Item Type: | Articles |
|---|---|
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Leyland, Professor Alastair |
| Authors: | Falster, M. O., Jorm, L. R., and Leyland, A. H. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU |
| Journal Name: | Health Services Research |
| Publisher: | Wiley |
| ISSN: | 0017-9124 |
| ISSN (Online): | 1475-6773 |
| Published Online: | 22 September 2017 |
| Copyright Holders: | Copyright © 2017 The Authors |
| First Published: | First published in Health Services Research 53(S1): 3148-3169 |
| Publisher Policy: | Reproduced under a Creative Commons License |
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