Go with the Flow? A Large-Scale Analysis of Health Care Delivery Networks in the United States Using Hodge Theory

Thomas Gebhart, Xiaojun Fu, Russell J. Funk

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

Health care delivery is a collaborative process, requiring close coordination among networks of providers with specialized expertise. Yet in the United States, care is often spread across multiple disconnected providers (e.g., primary care physicians, specialists), leading to fragmented care delivery networks, and contributing to higher costs and lower quality. While this problem is well known, there are relatively few quantitative tools available for characterizing the dynamics of care delivery networks at scale, thereby inhibiting deeper understanding of care fragmentation and efforts to address it. In this, study, we conduct a large-scale analysis of care delivery networks across the United States using the discrete Hodge decomposition, an emerging method of topological data analysis. Using this technique, we decompose networks of patient flows among physicians into three orthogonal subspaces: gradient (acyclic flow), harmonic (global cyclic flow), and curl (local cyclic flow). We document substantial variation in the relative importance of each subspace, suggesting that there may be systematic differences in the organization of care delivery networks across health care markets. Moreover, we find that the relative importance of each subspace is predictive of local care cost and quality, with outcomes tending to be better with greater curl flow and worse with greater harmonic flow.

Original languageEnglish (US)
Title of host publicationProceedings - 2021 IEEE International Conference on Big Data, Big Data 2021
EditorsYixin Chen, Heiko Ludwig, Yicheng Tu, Usama Fayyad, Xingquan Zhu, Xiaohua Tony Hu, Suren Byna, Xiong Liu, Jianping Zhang, Shirui Pan, Vagelis Papalexakis, Jianwu Wang, Alfredo Cuzzocrea, Carlos Ordonez
PublisherInstitute of Electrical and Electronics Engineers Inc.
Pages3812-3823
Number of pages12
ISBN (Electronic)9781665439022
DOIs
StatePublished - 2021
Event2021 IEEE International Conference on Big Data, Big Data 2021 - Virtual, Online, United States
Duration: Dec 15 2021Dec 18 2021

Publication series

NameProceedings - 2021 IEEE International Conference on Big Data, Big Data 2021

Conference

Conference2021 IEEE International Conference on Big Data, Big Data 2021
Country/TerritoryUnited States
CityVirtual, Online
Period12/15/2112/18/21

Bibliographical note

Publisher Copyright:
© 2021 IEEE.

Keywords

  • Hodge theory
  • health care
  • topological data analysis

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