Organizing space: an empirical study of patient transfer relations between U.S. hospitals

Conaldi, Guido, Iwashyna, Theodore, Lomi, Alessandro and Pallotti, Francesca (2012) Organizing space: an empirical study of patient transfer relations between U.S. hospitals. In: Sunbelt XXXII International Network for Social Network Analysis Annual Conference, 12-18 Mar 2012, Redondo Beach, CA, USA. (Unpublished)

Abstract

We examine how spatial and social structures interact to shape the network of patient transfer relations within the population of U.S. hospitals. We interpret the presence of patient transfer ties as a signal for an underlying collaborative relationship between the hospitals involved. We specify and estimate Exponential Random Graph Models (ERGM) of interorganizational networks including the four main U.S. Census Regions (West, Mid-West, North-East and South). Controlling for major geographical and institutional factors and for important hospital-specific characteristics, we find that inter-hospital patient-transfer networks are characterized by strong general tendencies toward reciprocity and transitivity. Collaboration is more likely to be observed between reciprocating hospitals, and between hospitals sharing multiple partners. We also find significant differences in degree distributions across Census Regions: for example, the tendency toward centralization in activity (out-degree) and popularity (in-degrees) of hospitals varies significantly across spatial settings. Finally, we report that endogenous network-based processes and the negative effect of geographical distance both influence the presence of collaborative patient transfer relations between hospitals. Considered together, these results represent a starting point for investigating further the interdependencies between the spatial and social dimensions of interorganizational fields.

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