Social network analysis for medical narcotics in South Korea: focusing on patients and healthcare organizations

Abstract

Abstract Background: Medical narcotics must be administered under medical supervision because of their potential for misuse and abuse, leading to more dangerous and addictive substances. The control of medical narcotics requires close monitoring to ensure that they remain safe and effective. This study proposes a methodology that can effectively identify the overprescription of medical narcotics in hospitals and patients. Methods: Social network analysis (SNA) was applied to prescription networks for medical narcotics. Prescription data were obtained from the Narcotics Information Management System (NIMS) in South Korea, which contains all data narcotic usage nationwide. Two-mode networks comprising hospitals and patients were constructed based on comprehensive prescription data from 2020 to 2021 for three major narcotics: appetite suppressants, Zolpidem, and Propofol. Two-mode networks were then converted into one-mode networks for hospitals. Network structures and characteristics were analyzed to identify hospitals suspected of overprescribing and propose a method to better control medical narcotics. Results: The SNA identified hospitals that overprescribed medical narcotics. Patients suspected of experiencing narcotic addiction seek treatment in such hospitals. The structure of the network was also different for the three narcotics; while appetite suppressants and propofol networks had a more centralized structure; zolpidem networks showed a less centralized but more fragmented structure. During the analysis of the two-mode networks, two types of hospitals caught our attention: one with a high degree, meaning that potential abusers have frequently visited the hospital, and the other with a high weighted degree, meaning that the hospital may overprescribe. For appetite suppressants, these two types of hospitals matched 84.6%, compared with 30.0% for Propofol. Regarding hospital size, clinics had the largest share of the network, with the highest degree for the three narcotics. Zolpidem had the highest weighted degree in clinics, and Propofol had the highest weighted degree in general hospitals. Patients using appetite suppressants were most likely to visit multiple locations, whereas those using Zolpidem and Propofol tended to form communities around their neighborhoods. Conclusions: This study presented a network analysis of prescriptions for all medical narcotics across the country. The significance of this study lies in its analysis of nationwide narcotic use reports and the differences observed across different types of narcotics. The social network structure between hospitals and patients varies depending on the composition of the medical narcotics. Therefore, these characteristics should be considered when controlling medication with narcotics. The results of this study provide guidelines for controlling narcotic use in other countries.