Oral Health and High-Complexity Networks: A Functional Interdependence Analysis via Health Information Systems.

Abstract

Aim: This study analysed the integration levels and co-assistance patterns of the dentistry service within a high-complexity hospital in Paraguay, under the framework of Integrated Health Service Delivery Networks (IHSDN).

Methods: Using a retrospective observational design, Big Data from the Hospital Information System (HIS) were processed between March and August 2025. Care trajectories and functional interdependence with 19 clinical services were evaluated using network analysis techniques in RStudio, with associations determined through Relative Risk (RR).

Results: The results demonstrate an operational integration network in which dental functions complement one another, yet with a predominant linkage to Internal Medicine Emergency services (n = 397). A low density of interdependence was detected with strategic specialties for chronic disease management, such as Cardiology (n = 97) and Diabetology (n = 79). A critical finding was that patients accessing services through scheduled care were 4.16 times more likely to receive proactive and continuous care than those entering through emergency departments (RR = 4.16; 95% CI; p < 0.001). Furthermore, a capacity gap was observed: while global hospital demand grew by 10.2%, the dental supply only increased by 0.5%. In light of these arguments, although the IHSDN structure is solid, its operability remains reactive and fragmented.

Conclusions: The study demonstrates that scheduled management is the key to quadrupling care integration. The HIS is positioned as an essential governance tool to identify bottlenecks, eliminate access barriers, and strengthen proactive referrals, ensuring that oral health is effectively integrated into the comprehensive care of patients with chronic conditions.