Department of Pediatrics, University of British Columbia, Child & Family Research Institute, 4480 Oak Street, Vancouver BC, V6H 3N1, Canada. hsiden@cw.bc.ca
Continuity of care is a key component of care in complex and chronic conditions. Despite its importance, it is often absent in chronic-disease management. One challenge has been identifying tools to measure care continuity. In one context important to families, namely pediatric palliative care, we undertook a project to identify continuity and to pilot the use of network analysis as a tool.
Network analysis studies patterns of relationships or interactions between members, providing qualitative and quantitative description of network structure.
In this report we applied network analysis to paper records of clinical consultations and reports for 6 patients with complex conditions. A high degree of discontinuity was identified, and care was fragmented amongst specialist and generalist providers. Information was shared selectively and often moved in only one direction.
Families have anecdotally reported frustration with poor continuity of care. Network analysis can be a useful tool in describing the discontinuity of care experienced by families dealing with complex and chronic conditions. This tool could be expanded to other systems such as electronic health records and many other health care situations.
Notes
Cites: BMJ. 2003 Nov 22;327(7425):1219-2114630762
Cites: Can Oncol Nurs J. 2004 Summer;14(3):183-6, 188-9115379377
Cites: Ann Fam Med. 2004 Sep-Oct;2(5):445-5115506579
Cites: Am J Psychiatry. 1972 Aug;129(2):196-2015041060
Cites: Med Care. 1981 Jul;19(7):741-586455572
Cites: Med Care. 1982 Apr;20(4):347-606210811
Cites: Health Serv Res. 2009 Apr;44(2 Pt 2):717-3821456113
Cites: Can Oncol Nurs J. 2004 Fall;14(4):224-3215635896
Cites: Can Oncol Nurs J. 2005 Winter;15(1):4-1415779778
Cites: Ann Fam Med. 2005 Sep-Oct;3(5):443-816189061
Cites: Aust J Rural Health. 2007 Apr;15(2):99-10617441818
Cites: Science. 2009 Feb 13;323(5916):892-519213908