IDEAS home Printed from https://ideas.repec.org/a/eee/jhecon/v43y2015icp56-73.html
   My bibliography  Save this article

Old boys’ network in general practitioners’ referral behavior?

Author

Listed:
  • Hackl, Franz
  • Hummer, Michael
  • Pruckner, Gerald J.

Abstract

We analyzed the impact of social networks on general practitioners’ (GPs) referral behavior based on administrative panel data from 2,684,273 referrals to specialists made between 1998 and 2007. For the definition of social networks, we used information on the doctors’ place and time of study and their hospital work history. We found that GPs referred more patients to specialists within their personal networks and that patients referred within a social network had fewer follow-up consultations and less inpatient days thereafter. The effects on patient outcomes (e.g. waiting periods, days in hospital) of referrals within personal networks and affinity-based networks differed. Specifically, whereas empirical evidence showed a concentration on high-quality specialists for referrals within the personal network, suggesting that referrals within personal networks overcome information asymmetry with respect to specialists’ abilities, the empirical evidence for affinity-based networks was different and less clear. Same-gender networks tended to refer patients to low-quality specialists.

Suggested Citation

  • Hackl, Franz & Hummer, Michael & Pruckner, Gerald J., 2015. "Old boys’ network in general practitioners’ referral behavior?," Journal of Health Economics, Elsevier, vol. 43(C), pages 56-73.
  • Handle: RePEc:eee:jhecon:v:43:y:2015:i:c:p:56-73
    DOI: 10.1016/j.jhealeco.2015.06.005
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0167629615000715
    Download Restriction: Full text for ScienceDirect subscribers only

    File URL: https://libkey.io/10.1016/j.jhealeco.2015.06.005?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to look for a different version below or search for a different version of it.

    Other versions of this item:

    References listed on IDEAS

    as
    1. Gompers, Paul A. & Mukharlyamov, Vladimir & Xuan, Yuhai, 2016. "The cost of friendship," Journal of Financial Economics, Elsevier, vol. 119(3), pages 626-644.
    2. Lauren Cohen & Andrea Frazzini & Christopher Malloy, 2008. "The Small World of Investing: Board Connections and Mutual Fund Returns," Journal of Political Economy, University of Chicago Press, vol. 116(5), pages 951-979, October.
    3. Marinoso, Begona Garcia & Jelovac, Izabela, 2003. "GPs' payment contracts and their referral practice," Journal of Health Economics, Elsevier, vol. 22(4), pages 617-635, July.
    4. Adriaan R. Soetevent, 2006. "Empirics of the Identification of Social Interactions; An Evaluation of the Approaches and Their Results," Journal of Economic Surveys, Wiley Blackwell, vol. 20(2), pages 193-228, April.
    5. Anthony, Denise, 2003. "Changing the nature of physician referral relationships in the US: the impact of managed care," Social Science & Medicine, Elsevier, vol. 56(10), pages 2033-2044, May.
    6. J. M. C. Santos Silva & Silvana Tenreyro, 2006. "The Log of Gravity," The Review of Economics and Statistics, MIT Press, vol. 88(4), pages 641-658, November.
    7. Peter Egger & Michael Pfaffermayr, 2003. "The proper panel econometric specification of the gravity equation: A three-way model with bilateral interaction effects," Empirical Economics, Springer, vol. 28(3), pages 571-580, July.
    8. Stephen C. Earwicker & David K. Whynes, 1998. "General practitioners' referral thresholds and choices of referral destination: an experimental study," Health Economics, John Wiley & Sons, Ltd., vol. 7(8), pages 711-722, December.
    9. Charles F. Manski, 2000. "Economic Analysis of Social Interactions," Journal of Economic Perspectives, American Economic Association, vol. 14(3), pages 115-136, Summer.
    10. Phelps, Edmund S, 1972. "The Statistical Theory of Racism and Sexism," American Economic Review, American Economic Association, vol. 62(4), pages 659-661, September.
    11. Allard, Marie & Jelovac, Izabela & Léger, Pierre Thomas, 2011. "Treatment and referral decisions under different physician payment mechanisms," Journal of Health Economics, Elsevier, vol. 30(5), pages 880-893.
    12. Sørensen, Torben Højmark & Olsen, Kim Rose & Vedsted, Peter, 2009. "Association between general practice referral rates and patients' socioeconomic status and access to specialised health care: A population-based nationwide study," Health Policy, Elsevier, vol. 92(2-3), pages 180-186, October.
    13. Hanming Fang & Andrea Moro, 2010. "Theories of Statistical Discrimination and Affirmative Action: A Survey," NBER Working Papers 15860, National Bureau of Economic Research, Inc.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Michael Berger & Thomas Czypionka, 2021. "Regional medical practice variation in high-cost healthcare services," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(6), pages 917-929, August.
    2. Frimmel, Wolfgang & Pruckner, Gerald J., 2020. "Retirement and healthcare utilization," Journal of Public Economics, Elsevier, vol. 184(C).
    3. Alexander Ahammer, 2018. "Physicians, sick leave certificates, and patients' subsequent employment outcomes," Health Economics, John Wiley & Sons, Ltd., vol. 27(6), pages 923-936, June.
    4. Berger, Michael & Czypionka, Thomas, 2021. "Regional medical practice variation in high-cost healthcare services: evidence from diagnostic imaging in Austria," LSE Research Online Documents on Economics 112952, London School of Economics and Political Science, LSE Library.
    5. Barkowski, Scott, 2021. "Physician Response to Prices of Other Physicians: Evidence from a Field Experiment," MPRA Paper 108966, University Library of Munich, Germany.
    6. Steinhauer, Andreas & Bíró, Anikó & Dieterle, Steven, 2019. "Motherhood Timing and the Child Penalty: Bounding the Returns to Delay," CEPR Discussion Papers 13732, C.E.P.R. Discussion Papers.
    7. Kummer, Michael E. & Laitenberger, Ulrich & Rich, Cyrus E. & Hughes, Danny R. & Ayer, Turgay, 2021. "Healthy reviews! Online physician ratings reduce healthcare interruptions," ZEW Discussion Papers 21-075, ZEW - Leibniz Centre for European Economic Research.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Andersson, Fredrik W. & Bokenblom, Mattias & Brantingson, Staffan & Brännström, Susanne Gullberg & Wall, Johan, 2011. "Sick listing—Partly a family phenomenon?," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 40(5), pages 496-502.
    2. Maria Cipollina & Luca De Benedictis & Luca Salvatici & Claudio Vicarelli, 2016. "Policy Measurement And Multilateral Resistance In Gravity Models," Working Papers LuissLab 16130, Dipartimento di Economia e Finanza, LUISS Guido Carli.
    3. Bet Caeyers, 2014. "Peer effects in development programme awareness of vulnerable groups in rural Tanzania," CSAE Working Paper Series 2014-11, Centre for the Study of African Economies, University of Oxford.
    4. Godager, Geir & Iversen, Tor & Ma, Ching-to Albert, 2015. "Competition, gatekeeping, and health care access," Journal of Health Economics, Elsevier, vol. 39(C), pages 159-170.
    5. Abdoulaye Seck, 2017. "How Facilitating Trade would Benefit Trade in Sub-Saharan Africa," Journal of African Development, African Finance and Economic Association (AFEA), vol. 19(1), pages 1-26.
    6. Tor Iversen & Ching-to Ma, 2011. "Market conditions and general practitioners’ referrals," International Journal of Health Economics and Management, Springer, vol. 11(4), pages 245-265, December.
    7. Marie Allard & Izabela Jelovac & Pierre-Thomas Léger, 2014. "Payment mechanism and GP self-selection: capitation versus fee for service," International Journal of Health Economics and Management, Springer, vol. 14(2), pages 143-160, June.
    8. Andreas Hatzigeorgiou & Magnus Lodefalk, 2016. "Migrants’ Influence on Firm-level Exports," Journal of Industry, Competition and Trade, Springer, vol. 16(4), pages 477-497, December.
    9. Wessel, Jan, 2019. "Evaluating the transport-mode-specific trade effects of different transport infrastructure types," Transport Policy, Elsevier, vol. 78(C), pages 42-57.
    10. Claudia Senik & Thierry Verdier, 2011. "Segregation, entrepreneurship and work values: the case of France," Journal of Population Economics, Springer;European Society for Population Economics, vol. 24(4), pages 1207-1234, October.
    11. Jessen, Jonas & Jessen, Robin & Kluve, Jochen, 2019. "Punishing potential mothers? Evidence for statistical employer discrimination from a natural experiment," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 59, pages 164-172.
    12. Marie Allard & Izabela Jelovac & Pierre-Thomas Léger, 2010. "Physicians self selection of a payment mechanism: Capitation versus fee-for-service," Post-Print halshs-00523370, HAL.
    13. Cecilio R. Tamarit Escalona & Estrella Gómez, 2011. "The euro effect on trade: evidence in gravity equations using panel cointegration techniques," Working Papers. Serie EC 2011-07, Instituto Valenciano de Investigaciones Económicas, S.A. (Ivie).
    14. Haq, Zahoor Ul & Meilke, Karl D. & Cranfield, John A.L., 2011. "The Gravity Model and the Problem of Zero's in Agrifood Trade," Working Papers 116851, Canadian Agricultural Trade Policy Research Network.
    15. Daumal, Marie, 2008. "Federalism, separatism and international trade," European Journal of Political Economy, Elsevier, vol. 24(3), pages 675-687, September.
    16. Lehmann, Jee-Yeon, 2011. "Job assignment and promotion under statistical discrimination: evidence from the early careers of lawyers," MPRA Paper 33466, University Library of Munich, Germany.
    17. Gerardo Pérez‐Cavazos, 2019. "Consequences of Debt Forgiveness: Strategic Default Contagion and Lender Learning," Journal of Accounting Research, Wiley Blackwell, vol. 57(3), pages 797-841, June.
    18. Silviano Esteve-Pérez & Salvador Gil-Pareja & Rafael Llorca-Vivero, 2020. "Does the GATT/WTO promote trade? After all, Rose was right," Review of World Economics (Weltwirtschaftliches Archiv), Springer;Institut für Weltwirtschaft (Kiel Institute for the World Economy), vol. 156(2), pages 377-405, May.
    19. Christa Brelsford & Caterina De Bacco, 2018. "Are `Water Smart Landscapes' Contagious? An epidemic approach on networks to study peer effects," Papers 1801.10516, arXiv.org.
    20. Kareem, Fatima Olanike & Martinez-Zarzoso, Inmaculada & Brümmer, Bernhard, 2016. "Fitting the Gravity Model when Zero Trade Flows are Frequent: a Comparison of Estimation Techniques using Africa's Trade Data," GlobalFood Discussion Papers 230588, Georg-August-Universitaet Goettingen, GlobalFood, Department of Agricultural Economics and Rural Development.

    More about this item

    Keywords

    Referral behavior; General practitioner; Information asymmetry; Personal networks; Affinity-based networks;
    All these keywords.

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:jhecon:v:43:y:2015:i:c:p:56-73. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/locate/inca/505560 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.