ArticleHealth services research2020
Measures of care fragmentation: Mathematical insights from population genetics.
Article in Health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Fragmented care and chronic illness patient outcomes: A systematic review.Nursing open · 2023Pooled it
- The consequences of medicine shortages on healthcare utilization and care fragmentation.The European journal of health economics : HEPAC : health economics in prevention and care · 2026Article
- The telehealth engagement measure: a proportions-based measure of care delivered via video and phone for research, clinical, and policy assessments.JAMIA open · 2026Article
- Article
- Mathematical bounds on rTheoretical population biology · 2025Article
- Data-driven insights into interhospital care fragmentation: Implications for health policy and equity among older adults.PloS one · 2025Article
- Mathematical bounds onbioRxiv : the preprint server for biology · 2024Article
- Association of polydoctoring and mortality among persons over 85 years with multimorbidity: a prospective cohort study in Japan.BJGP open · 2024Article
- Measurement of polydoctoring as a crucial component of fragmentation of care among patients with multimorbidity: Cross-sectional study in Japan.Journal of general and family medicine · 2023Article
- Healthcare fragmentation, multimorbidity, potentially inappropriate medication, and mortality: a Danish nationwide cohort study.BMC medicine · 2023Article
- Distinct health care use patterns of patients with chronic gastrointestinal diseases.The American journal of managed care · 2023Observational
- Association Between Mental Health Conditions and Outpatient Care Fragmentation: a National Study of Older High-Risk Veterans.Journal of general internal medicine · 2022Article
- Outpatient care fragmentation in Veterans Affairs patients at high-risk for hospitalization.Health services research · 2022Article
- Measures of care fragmentation: Mathematical insights from population genetics.Health services research · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
Abstract
objectiveTo identify novel properties of health care fragmentation measures, drawing on insights from mathematically equivalent measures of genetic diversity. STUDY
designWe describe mathematical relationships between two measures: (a) Breslau's Usual Provider of Care (UPC), the proportion of care with the most frequently visited provider, analogous to the "frequency of the most frequent allele" at a genetic locus; and (b) Bice-Boxerman's Continuity of Care Index (COCI), a measure of care dispersion across multiple providers, analogous to "Nei's estimator of homozygosity" in genetics. PRINCIPAL
findingsJust as the frequency of the most frequent allele places a tight constraint on homozygosity, the proportion of care with the most frequently visited provider (UPC) places lower and upper bounds on dispersion of care (COCI), and vice versa. This property presents the possibility of a normalized COCI given UPC (NCGU) measure, which reflects a bounded range of care dispersion dependent on the number of visits with the most frequently visited provider. Mathematical aspects of UPC and COCI also suggest thresholds for the minimal number of patient visits to use when studying fragmentation.
conclusionsApplying knowledge from population genetics elucidated relationships between care fragmentation measures and produced novel insights for care fragmentation studies.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.