Patient-sharing networks among Finnish primary healthcare professionals taking care of patients with mental health or substance use problems: a register study

Objectives Patient-sharing networks based on administrative data are used to understand the organisation of healthcare. We examined the patient-sharing networks between different professionals taking care of patients with mental health or substance use problems.Design Register study based on the Reg...

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Main Authors: Christian Hakulinen, Marko Elovainio, Jaana Suvisaari, Timo Sinervo, Laura Hietapakka, Visa Väisänen, Ripsa Niemi, Mai Gutvilig, Outi Linnaranta
Format: Article
Language:English
Published: BMJ Publishing Group 2025-01-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/1/e089111.full
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author Christian Hakulinen
Marko Elovainio
Jaana Suvisaari
Timo Sinervo
Laura Hietapakka
Visa Väisänen
Ripsa Niemi
Mai Gutvilig
Outi Linnaranta
author_facet Christian Hakulinen
Marko Elovainio
Jaana Suvisaari
Timo Sinervo
Laura Hietapakka
Visa Väisänen
Ripsa Niemi
Mai Gutvilig
Outi Linnaranta
author_sort Christian Hakulinen
collection DOAJ
description Objectives Patient-sharing networks based on administrative data are used to understand the organisation of healthcare. We examined the patient-sharing networks between different professionals taking care of patients with mental health or substance use problems.Design Register study based on the Register of Primary Health Care visits (Avohilmo) that covers all outpatient primary health care visits in Finland.Setting We used the register data covering the visits for the service providers of seven municipalities, adult patients with at least one visit to a health and social service centre within one of the municipalities and visits during the year 2021.Participants We first selected patients with mental health or substance use problems based on psychiatric diagnoses and information on service type and then identified the professionals (N=1566) visited. A patient-sharing relationship was defined between two professionals if a same patient had visited both of them at least once.Primary outcome measures We analysed the potential associations of the network structure and the nodal attributes (municipality, belonging to a certain occupational group and the service type) with nodal formation using Exponential Random Graph Models.Results The main findings showed that two professionals were more likely to share patient(s) when they belonged to the same occupational group, provided similar types of services or worked in the same municipality. Being a physician was associated with having more connections to other professionals than belonging to other occupational groups (OR for nurses 0.70, 95% CI 0.69 to 0.7 and for other occupations 0.83, 95% CI 0.81 to 0.84). Shared patients among different professionals were also more probable when the patients were shared with the professionals working within mental health or substance use services compared with outpatient healthcare services (OR 1.64, 95% CI 1.61 to 1.67).Conclusions Patient-sharing contacts were mainly homogenous, supporting the tendency of people to have connections with similar people. The results also highlight the role of the physicians as important partners in the patient-sharing networks.
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spelling doaj-art-ed21bc52b60a453bb7f1ce3ee1b167cf2025-01-06T18:25:09ZengBMJ Publishing GroupBMJ Open2044-60552025-01-0115110.1136/bmjopen-2024-089111Patient-sharing networks among Finnish primary healthcare professionals taking care of patients with mental health or substance use problems: a register studyChristian Hakulinen0Marko Elovainio1Jaana Suvisaari2Timo Sinervo3Laura Hietapakka4Visa Väisänen5Ripsa Niemi6Mai Gutvilig7Outi Linnaranta81 Finnish Institute for Health and Welfare, Helsinki, Finland1 Finnish Institute for Health and Welfare, Helsinki, Finland1 Finnish Institute for Health and Welfare, Helsinki, Finland1 Finnish Institute for Health and Welfare, Helsinki, Finland1 Finnish Institute for Health and Welfare, Helsinki, Finland1 Finnish Institute for Health and Welfare, Helsinki, Finland1 Finnish Institute for Health and Welfare, Helsinki, Finland1 Finnish Institute for Health and Welfare, Helsinki, Finland1 Finnish Institute for Health and Welfare, Helsinki, FinlandObjectives Patient-sharing networks based on administrative data are used to understand the organisation of healthcare. We examined the patient-sharing networks between different professionals taking care of patients with mental health or substance use problems.Design Register study based on the Register of Primary Health Care visits (Avohilmo) that covers all outpatient primary health care visits in Finland.Setting We used the register data covering the visits for the service providers of seven municipalities, adult patients with at least one visit to a health and social service centre within one of the municipalities and visits during the year 2021.Participants We first selected patients with mental health or substance use problems based on psychiatric diagnoses and information on service type and then identified the professionals (N=1566) visited. A patient-sharing relationship was defined between two professionals if a same patient had visited both of them at least once.Primary outcome measures We analysed the potential associations of the network structure and the nodal attributes (municipality, belonging to a certain occupational group and the service type) with nodal formation using Exponential Random Graph Models.Results The main findings showed that two professionals were more likely to share patient(s) when they belonged to the same occupational group, provided similar types of services or worked in the same municipality. Being a physician was associated with having more connections to other professionals than belonging to other occupational groups (OR for nurses 0.70, 95% CI 0.69 to 0.7 and for other occupations 0.83, 95% CI 0.81 to 0.84). Shared patients among different professionals were also more probable when the patients were shared with the professionals working within mental health or substance use services compared with outpatient healthcare services (OR 1.64, 95% CI 1.61 to 1.67).Conclusions Patient-sharing contacts were mainly homogenous, supporting the tendency of people to have connections with similar people. The results also highlight the role of the physicians as important partners in the patient-sharing networks.https://bmjopen.bmj.com/content/15/1/e089111.full
spellingShingle Christian Hakulinen
Marko Elovainio
Jaana Suvisaari
Timo Sinervo
Laura Hietapakka
Visa Väisänen
Ripsa Niemi
Mai Gutvilig
Outi Linnaranta
Patient-sharing networks among Finnish primary healthcare professionals taking care of patients with mental health or substance use problems: a register study
BMJ Open
title Patient-sharing networks among Finnish primary healthcare professionals taking care of patients with mental health or substance use problems: a register study
title_full Patient-sharing networks among Finnish primary healthcare professionals taking care of patients with mental health or substance use problems: a register study
title_fullStr Patient-sharing networks among Finnish primary healthcare professionals taking care of patients with mental health or substance use problems: a register study
title_full_unstemmed Patient-sharing networks among Finnish primary healthcare professionals taking care of patients with mental health or substance use problems: a register study
title_short Patient-sharing networks among Finnish primary healthcare professionals taking care of patients with mental health or substance use problems: a register study
title_sort patient sharing networks among finnish primary healthcare professionals taking care of patients with mental health or substance use problems a register study
url https://bmjopen.bmj.com/content/15/1/e089111.full
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