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Social network analysis in primary care: The impact of interactions on prescribing behaviour


  • Fattore, Giovanni
  • Frosini, Francesca
  • Salvatore, Domenico
  • Tozzi, Valeria


Objectives In many healthcare systems of affluent countries, general practitioners (GPs) are encouraged to work in collaborative arrangements to increase patients' accessibility and the quality of care. There are two lines of thought regarding the ways in which belonging to a network can affect GP behaviour: (1) the social capital framework posits that, through relationships, individuals acquire resources, such as information, that allow them to perform better; and (2) the social influence framework sees relationships as avenues through which individual actors influence other individuals and through which behavioural norms are developed and enforced. The objective of this study is to provide an evaluation of the effects of GP network organisation on their prescribing behaviour.Methods We used administrative data from a Local Health Authority (LHA) in Italy concerning GPs organisation and prescriptions.Results We found that GPs working in a collaborative arrangement have a similar prescribing behaviour while we did not find a significant relationship between the centrality of a GP and her capability to meet LHA's targets.Conclusions Our data support the conclusion that, in the case of GP collaboration initiatives, the social influence mechanism is more relevant than the social capital mechanism.

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  • Fattore, Giovanni & Frosini, Francesca & Salvatore, Domenico & Tozzi, Valeria, 2009. "Social network analysis in primary care: The impact of interactions on prescribing behaviour," Health Policy, Elsevier, vol. 92(2-3), pages 141-148, October.
  • Handle: RePEc:eee:hepoli:v:92:y:2009:i:2-3:p:141-148

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    References listed on IDEAS

    1. de Jong, Judith D. & Groenewegen, Peter P. & Westert, Gert P., 2003. "Mutual influences of general practitioners in partnerships," Social Science & Medicine, Elsevier, vol. 57(8), pages 1515-1524, October.
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    3. West, Elizabeth & Barron, David N. & Dowsett, Juliet & Newton, John N., 1999. "Hierarchies and cliques in the social networks of health care professionals: implications for the design of dissemination strategies," Social Science & Medicine, Elsevier, vol. 48(5), pages 633-646, March.
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    Cited by:

    1. Chiara Seghieri & Alessandro Mengoni & Sabina Nuti, 2014. "Applying discrete choice modelling in a priority setting: an investigation of public preferences for primary care models," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(7), pages 773-785, September.
    2. Mascia, Daniele & Dandi, Roberto & Di Vincenzo, Fausto, 2014. "Professional networks and EBM use: A study of inter-physician interaction across levels of care," Health Policy, Elsevier, vol. 118(1), pages 24-36.
    3. Sara Barsanti & Manila Bonciani & Federico Vola & Luca Pirisi, 2016. "Innovatori, indecisi, bisognosi o autonomi. I medici di medicina generale tra integrazione e accountability," MECOSAN. Menagement e economia sanitaria, FrancoAngeli Editore, vol. 2016(98), pages 9-39.
    4. Dunn, Adam G. & Westbrook, Johanna I., 2011. "Interpreting social network metrics in healthcare organisations: A review and guide to validating small networks," Social Science & Medicine, Elsevier, vol. 72(7), pages 1064-1068, April.
    5. Fiorentini, Gianluca & Lippi Bruni, Matteo & Ugolini, Cristina, 2013. "GPs and hospital expenditures. Should we keep expenditure containment programs alive?," Social Science & Medicine, Elsevier, vol. 82(C), pages 10-20.
    6. Huesch, Marco D., 2011. "Is blood thicker than water? Peer effects in stent utilization among Floridian cardiologists," Social Science & Medicine, Elsevier, vol. 73(12), pages 1756-1765.
    7. Donatini A. & Fiorentini G. & Lippi Bruni M. & Mammi I. & Ugolini C., 2014. "Dealing with minor illnesses: the link between primary care characteristics and First Aid Clinics’ attendances," Working Papers wp925, Dipartimento Scienze Economiche, Universita' di Bologna.
    8. Visca, Modesta & Donatini, Andrea & Gini, Rosa & Federico, Bruno & Damiani, Gianfranco & Francesconi, Paolo & Grilli, Leonardo & Rampichini, Carla & Lapini, Gabriele & Zocchetti, Carlo & Di Stanislao,, 2013. "Group versus single handed primary care: A performance evaluation of the care delivered to chronic patients by Italian GPs," Health Policy, Elsevier, vol. 113(1), pages 188-198.
    9. Lippi Bruni, Matteo & Mammi, Irene & Ugolini, Cristina, 2016. "Does the extension of primary care practice opening hours reduce the use of emergency services?," Journal of Health Economics, Elsevier, vol. 50(C), pages 144-155.
    10. Hannemann-Weber, Henrike & Kessel, Maura & Schultz, Carsten, 2012. "Research performance of centers of expertise for rare diseases—The influence of network integration, internal resource access and operational experience," Health Policy, Elsevier, vol. 105(2), pages 138-145.
    11. Ugolini, Cristina & Lippi Bruni, Matteo & Mammi, Irene & Donatini, Andrea & Fiorentini, Gianluca, 2016. "Dealing with minor illnesses: The link between primary care characteristics and Walk-in Centres’ attendances," Health Policy, Elsevier, vol. 120(1), pages 72-80.
    12. Jippes, Erik & Achterkamp, Marjolein C. & Brand, Paul L.P. & Kiewiet, Derk Jan & Pols, Jan & van Engelen, Jo M.L., 2010. "Disseminating educational innovations in health care practice: Training versus social networks," Social Science & Medicine, Elsevier, vol. 70(10), pages 1509-1517, May.


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