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Old Boys’ Network in General Practitioner’s Referral Behavior

  • Franz Hackl
  • Michael Hummer
  • Gerald Pruckner

We analyzed the impact of social networks on general practitioners’ (GPs) referral behavior based on administrative panel data from 2,684,273 referrals to resident specialists made between 1998 and 2007. To construct estimated 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 social networks and that patients referred within a social network had fewer follow-up consultations and were healthier as measured by the number of inpatient days. Consequently, referrals within social networks tended to decrease healthcare costs by overcoming information asymmetry with respect to specialists’ abilities. This is supported by evidence suggesting that within a social network, better specialists receive more referrals than worse specialists in the same network.

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File URL: http://www.econ.jku.at/papers/2013/wp1310.pdf
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Paper provided by Department of Economics, Johannes Kepler University Linz, Austria in its series Economics working papers with number 2013-10.

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Length: 49 pages
Date of creation: Jul 2013
Date of revision:
Handle: RePEc:jku:econwp:2013_10
Contact details of provider: Fax: +43 732-2468-8238
Web page: http://www.econ.jku.at/

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  1. Hanming Fang & Andrea Moro, 2010. "Theories of Statistical Discrimination and Affirmative Action: A Survey," NBER Working Papers 15860, National Bureau of Economic Research, Inc.
  2. 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.
  3. Lauren Cohen & Andrea Frazzini & Christopher Malloy, 2007. "The Small World of Investing: Board Connections and Mutual Fund Returns," NBER Working Papers 13121, National Bureau of Economic Research, Inc.
  4. Charles F. Manski, 2000. "Economic Analysis of Social Interactions," Journal of Economic Perspectives, American Economic Association, vol. 14(3), pages 115-136, Summer.
  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. Santos Silva, J.M.C & Tenreyro, Silvana, 2005. "The Log of Gravity," CEPR Discussion Papers 5311, C.E.P.R. Discussion Papers.
  7. Paul Gompers & Vladimir Mukharlyamov & Yuhai Xuan, 2012. "The Cost of Friendship," NBER Working Papers 18141, National Bureau of Economic Research, Inc.
  8. 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.
  9. Phelps, Edmund S, 1972. "The Statistical Theory of Racism and Sexism," American Economic Review, American Economic Association, vol. 62(4), pages 659-61, September.
  10. 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.
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