title: Connectedness of healthcare professionals involved in the treatment of patients with Parkinson's disease: a social networks study.
abstract: BACKGROUND
  Patients with chronic illness typically receive ambulatory treatment from multiple health professionals. Connectedness between these professionals may influence their clinical decisions and the coordination of patient care. We aimed to describe and analyze connectedness in a regional network of health professionals involved in ambulatory treatment of patients with Parkinson's disease (PD).
  
  
  METHODS
  Observational study with 104 health professionals who had joined a newly established network (ParkinsonNet) were asked to complete a pre-structured form to report on their professional contacts with others in the network. Using social networks methods, network measures were calculated for the total network and for the networks of individual health professionals. We planned to test differences between subgroups of health professionals regarding 12 network measures, using a random permutation method.
  
  
  RESULTS
  Ninety-six health professionals (92%) provided data on 101 professionals. The reciprocity of reported connections was 0.42 in the network of professional contacts. Measures characterizing the individual networks showed a wide variation; e.g., density varied between 0 and 100% (mean value 28.4%). Health professionals with ≥10 PD patients had higher values on 7 out of 12 network measures compare to those with < 10 PD patients (size, number of connections, two step reach, indegree centrality, outdegree centrality, inreach centrality, betweenness centrality). Primary care professionals had lower values on 11 out of 12 network measures (all but reach efficiency) compared to professionals who were affiliated with a hospital.
  
  
  CONCLUSIONS
  Our measure of professional connectedness proved to be feasible in a regional disease-specific network of health professionals. Network measures describing patterns in the professional contacts showed relevant variation across professionals. A higher caseload and an affiliation with a hospital were associated with stronger connectedness with other health professionals.
authors: Scientific Institute for Quality of Healthcare (IQ healthcare), Radboud University Nijmegen Medical Centre, P,O, Box 9101, 6500 HB Nijmegen, Nijmegen, Netherlands. M.Wensing@iq.umcn.nl.
authors: Michel
authors: M
authors: Wensing
authors: Martijn
authors: M
authors: van der Eijk
authors: Jan
authors: J
authors: Koetsenruijter
authors: Bastiaan R
authors: BR
authors: Bloem
authors: Marten
authors: M
authors: Munneke
authors: Marjan
authors: M
authors: Faber
mesh_terms: D000368:Aged; D000553:Ambulatory Care; D003266:Continuity of Patient Care; D003657:Decision Making; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D019370:Observation; D010300:Parkinson Disease / Q000628:therapy*; D011320:Primary Health Care; D012944:Social Support; D011795:Surveys and Questionnaires