A framework for administrative claim data to explore healthcare coordination and collaboration

Shahadat Uddin; Margaret Kelaher; Uma Srinivasan

doi:10.1071/AH15058

A framework for administrative claim data to explore healthcare coordination and collaboration

Aust Health Rev. 2016 Nov;40(5):500-510. doi: 10.1071/AH15058.

Authors

Shahadat Uddin¹, Margaret Kelaher², Uma Srinivasan³

Affiliations

¹ Centre for Complex Systems Research, Room 402, Civil Engineering Building (J05), University of Sydney, Sydney, NSW 2000, Australia.
² Melbourne School of Population and Global Health, The University of Melbourne, Level 4, Room 438, 207-221 Bouverie Street, Parkville, Vic. 3052, Australia. Email.
³ Capital Markets Cooperative Research Centre (CMCRC), 55 Harrington Road, The Rocks, Sydney, NSW 2000, Australia. Email.

PMID: 26567767
DOI: 10.1071/AH15058

Abstract

Previous studies have documented the application of electronic health insurance claim data for health services research purposes. In addition to administrative and billing details of healthcare services, insurance data reveal important information regarding professional interactions and/or links that emerge among healthcare service providers through, for example, informal knowledge sharing. By using details of such professional interactions and social network analysis methods, the aim of the present study was to develop a research framework to explore health care coordination and collaboration. The proposed framework was used to analyse a patient-centric care coordination network and a physician collaboration network. The usefulness of this framework and its applications in exploring collaborative efforts of different healthcare professionals and service providers is discussed.

Publication types

Review

MeSH terms

Attitude of Health Personnel
Cooperative Behavior*
Electronic Health Records
Health Information Exchange
Health Services Research
Humans
Insurance Claim Review*
Patient Care Management
Patient-Centered Care*
Social Support