The article by Funk and colleagues¹ in this issue of JAMA Surgery uses a network analysis to assess informal physician integration that arises from the shared care of multiple patients over time. They hypothesized that higher levels of informal integration would produce price-standardized total episode and component payments that were lower than those observed in health systems with lower indices. Their analysis supported the inference that deeper informal integration is associated with lower spending, specifically when related to readmissions and postacute care services, and that this difference might explain the limited efficacy of formal integration as mandated in accountable care organizations or patient-centered medical homes.

Funk及其同事¹在本期JAMA Surgery中的文章使用网络分析来评估非正式医生的整合，这种整合是由多个患者在一段时间内的共同护理而产生的。他们假设，较高水平的非正式融合将产生价格标准化的总发作和部分付费，低于在具有较低指数的卫生系统中观察到的费用。他们的分析支持这样的推论，即更深层次的非正式融合与较低的支出相关联，特别是与重新入院和急性病后护理服务相关的开支，并且这种差异可能解释了按责任关怀组织或以患者为中心的医疗院所要求的正式融合功效有限。