Background Japan has one of the highest densities of computed tomography (CT) and magnetic resonance imaging (MRI) scanners globally, yet efficient resource allocation remains a challenge amid demographic shifts and regional health care disparities. Objective This study aimed to develop an analytic framework using network analysis techniques to understand the collaborative use of CT and MRI devices across health care facilities in a Japanese prefecture. Methods A retrospective observational study was conducted using outpatient receipt data from Japan’s National Health Insurance and the Late-Stage Elderly Medical System, covering fiscal years 2016 to 2019. Network analysis techniques were used to identify patterns of shared use among medical institutions. Network graphs with community detection were developed to visualize collaborative relationships, and density and reciprocity metrics were calculated to assess interinstitutional cooperation. Results CT examinations increased from 287,782 (2016) to 307,029 (2019), while MRI examinations increased from 107,876 to 115,929 over the same period. Collaborative examinations also increased for both modalities. Network density remained relatively stable (CT: 3.10-3.50×10-3; MRI: 3.20-3.70×10-3), while reciprocity decreased (CT: 9.74×10-2 to 7.79×10-2; MRI: 2.82×10-2 to 1.56×10-2). Community detection analysis showed differences in the distribution of medical institutions across clusters over time. Conclusions Network analysis revealed structural changes in collaborative CT and MRI use patterns, including declining reciprocity, which suggests a shift toward more unidirectional referral patterns. This analytic framework provides a method for health care planners to assess interinstitutional collaboration and inform resource allocation strategies for shared diagnostic equipment.
Ishikawa et al. (Thu,) studied this question.