Provider Connectedness to Other Providers Reduces Risk of Readmission After Hospitalization for Heart Failure

Med Care Res Rev. 2019 Feb;76(1):115-128. doi: 10.1177/1077558717718626. Epub 2017 Jul 8.

Abstract

Provider interactions other than explicit care coordination, which is challenging to measure, may influence practice and outcomes. We performed a network analysis using claims data from a commercial payor. Networks were identified based on provider pairs billing outpatient care for the same patient. We compared network variables among patients who had and did not have a 30-day readmission after hospitalization for heart failure. After adjusting for comorbidities, high median provider connectedness-normalized degree, which for each provider is the number of connections to other providers normalized to the number of providers in the region-was the network variable associated with reduced odds of readmission after heart failure hospitalization (odds ratio = 0.55; 95% confidence interval [0.35, 0.86]). We conclude that heart failure patients with high provider connectedness are less likely to require readmission. The structure and importance of provider relationships using claims data merits further study.

Keywords: heart failure; patient care constellation; patient readmission; physicians; practice patterns.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Ambulatory Care / methods*
  • Female
  • Heart Failure / therapy*
  • Hospitalization*
  • Humans
  • Male
  • Middle Aged
  • Patient Readmission*