SocialNetworkAnalysisofPatientSharingAmong HospitalsinOrangeCounty,California

Bruce Y. Lee, MD, MBA, Sarah M. McGlone, MPH, Yeohan Song, Taliser R. Avery, BS, Stephen Eubank, PhD, Chung-Chou Chang, PhD, Rachel R. Bailey,MPH, Diane K. Wagener, PhD, Donald S. Burke, MD, Richard Platt, MD, and Susan S. Huang, MD, MPHIn many ways, hospitals in a county areanalogous to individual people within a socialnetwork. Both people and hospitals have in-dividualcharacteristics(e.g.,height,weight,age,and gender for people; bed capacity, facilitytype, and payer mix for hospitals). Peopleexhibit behaviors; hospitals implement policiesand interventions. Just as people are connectedby social ties and interactions, hospitals areoften connected to each other through sharingpatients, because patients discharged from onehospital may be admitted to other hospitalsinthesameregion.Similartosocialinteractionsamong people, patient sharing can have signif-icant implications for disease and patient-demographic epidemiology (e.g., hospital-acquired infections) and the impact of diseasecontrol measures, patient education and pre-vention programs, and fiscal policies.