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BMC Health Services Research
Published in: BMC Health Services Research 1/2017

Open Access 01-12-2017 | Hypothesis

The influential role of personal advice networks on general practitioners’ performance: a social capital perspective

Authors: Stefano Calciolari, Laura G. González-Ortiz, Federico Lega

Published in: BMC Health Services Research | Issue 1/2017

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Abstract

Background

In several health systems of advanced countries, reforms have changed primary care in the last two decades. The literature has assessed the effects of a variety of interventions and individual factors on the behavior of general practitioners (GPs). However, there has been a lack of investigation concerning the influence of the resources embedded in the GPs’ personal advice networks (i.e., social capital) on GPs’ capacity to meet defined objectives.
The present study has two goals: (a) to assess the GPs’ personal advice networks according to the social capital framework and (b) to test the influence of such relationships on GPs’ capacity to accomplish organizational goals.

Methods

The data collection relied on administrative data provided by an Italian local health authority (LHA) and a survey administered to the GPs of the selected LHA. The GPs’ personal advice networks were assessed through an ad-hoc instrument and interpreted as egocentric networks. Multivariate regression analyses assessed two different performance measures.

Results

Social capital may influence the GPs’ capacity to meet targets, though the influence differs according to the objective considered. In particular, the higher the professional heterogeneity of a GP personal advice network, the lower her/his capacity is to meet targets of prescriptive appropriateness.

Conclusions

Our findings might help to design more effective primary care reforms depending on the pursued goals. However, further research is needed.
Footnotes
1
Anatomical Therapeutic Chemical Classification System. The code “M05” identifies drugs for treatment of bone diseases.
 
2
Broncho-Pneumopathie Chronique Obstructive.
 
3
This index is computed by the LHA taking into account the age and gender of the patients enrolled with each GP. When the index is higher/lower than 1, it means that the average patient of a particular GP is more/less expensive than the average patience of the population.
 
Literature
1.
Fattore G, Frosini F, Salvatore D, Tozzi V. Social network analysis in primary care: The impact of interactions on prescribing behavior. Health Policy. 2009;92(2–3):141–8.CrossRefPubMed
2.
Visca M, Donatini A, Ginic R, Federico B, Damiani G, Francesconi P, Grilli L, Rampichini C, Lapini G, Zocchetti C, et al. Group versus single handed primary care: A performance evaluation of the care delivered to chronic patients by Italian GPs. Health Policy. 2013;113(1–2):188–98.CrossRefPubMed
3.
Grimshaw JM, Shirran L, Thomas R, Mowat G, Fraser C, Bero L, Grilli R, Harvey E, Oxman A, O'Brien MA. Changing provider behavior: an overview of systematic reviews of interventions. Med Care. 2001;39(8):112–45.
4.
Smolders M, Laurant M, Verhaak P, Prins M, van Marwijk H, Penninx B, Wensing M, Grol R. Which physician and practice characteristics are associated with adherence to evidence-based guidelines for depressive and anxiety disorders? Med Care. 2010;48(3):240–8.CrossRefPubMed
5.
Fattore G, Salvatore D. Network organizations of general practitioners: Antecedents of formation and consequences of participation. BMC Health Serv Res. 2010;10(118):1–12.
6.
7.
Malterud K. The Art and Science of Clinical Knowledge: Evidence Beyond Measures and Numbers. Lancet. 2001;358(9279):397–400.CrossRefPubMed
8.
Ferlie E, Fitzgerald L, W M, H C. The Nonspread of Innovations: The Mediating Role of Professionals. Acad Manag J. 2007;48(1):117–34.CrossRef
9.
Bohmer RMJ. Designing Care: Aligning the nature and management of health care. Boston: Harvard Business Press; 2009.
10.
Kanouse D, Kallich J, Kahan J. Dissemination of effectiveness and outcomes research. Health Policy. 1995;34(3):167–92.CrossRefPubMed
11.
Nahapiet J, Ghoshal S. Social Capital, Intellectual Capital, and the Organizational Advantage. Acad Manag Rev. 1998;23(2):242–66.
12.
Burt RS. Structural holes: The social structure of competition. Cambridge, MA: Harvard University Press; 1992.
13.
Bourdieu P, Wacquant LJD. An invitation to reflexive sociology. Chicago: University of Chicago Press; 1992.
14.
Lin N. Social capital: A theory of social structure and action. Cambridge: Cambridge University Press; 2001.CrossRef
15.
Burt RS. Social Contagion and Innovation: Cohesion versus Structural Equivalence. Am J Sociol. 1987;92(6):1287–335.CrossRef
16.
Coleman JS. Social capital in the creation of human capital. Am J Sociol. 1988;94:S95–S120.CrossRef
17.
Adler PS, Kwon S-W. Social capital: Prospects for a new concept. Acad Manag Rev. 2002;27(1):17–40.
18.
Lawrence PR, Lorsch JW. Organization and environment: Managing differentiation and integration. Boston: Division of Research, Graduate School of Business Administration, Harvard University; 1967.
19.
McEvily B, Zaheer A. Bridging ties: A source of firm heterogeneity in competitive capabilities. Strateg Manag J. 1999;20(12):1133–56.CrossRef
20.
Nair HS, Manchanda P, Bhatia T. Asymmetric Social Interactions in Physician Prescription Behavior: The Role of Opinion Leaders. J Mark Res. 2010;47(5):883–95.CrossRef
21.
Salvatore D. Physician social capital: Its sources, configuration, and usefulness. Health Care Manag Rev. 2006;31(3):213–22.CrossRef
22.
Watkins C, Harvey I, Carthy P, Moore L, Robinson E, Brawn R. Attitudes and behaviour of general practitioners and their prescribing costs: A national cross sectional survey. Quality and Safety in Health Care. 2003;12(1):29–34.CrossRefPubMedPubMedCentral
23.
Meltzer D, Chunga J, Khalilia P, Marlowa E, Arora V, S G, B R. Exploring the use of social network methods in designing healthcare quality improvement teams. Soc Sci Med. 2010;71(6):1119–30.CrossRefPubMedPubMedCentral
24.
De Bakker DH, Coffie DSV, Heerdink ER, Van Dijk L, Groenewegen PP. Determinants of the range of drugs prescribed in general practice: a cross-sectional analysis. BMC Health Serv Res. 2007;7(132):1–10.
25.
Jensen UT, Andersen LB. Public Service Motivation, User Orientation, and Prescription Behaviour: Doing Good for Society or for the Individual User? Public Adm. 2015;93(3):753–68.CrossRef
26.
Anderson GF, Hussey PS. Population Ageing: A Comparison Among Industrialized Countries. Health Aff. 2000;19(3):191–203.CrossRef
27.
Gabe J, Williams P. Rural tranquillity? Urban-rural differences in tranquilliser prescribing. Soc Sci Med. 1986;22(10):1059–66.CrossRefPubMed
28.
29.
Pedhazur EJ, Pedhazur L. Measurement. Design and analysis: An integrated approach. Hillsdale: Lawrence Erlbaum Associates; 1991.
30.
Halgin DS, Borgatti SP. An introduction to personal network analysis and tie churn statistics using E-NET. Connect. 2012;32(1):36–48.
31.
Krackhardt D, Stern R. Informal networks and organizational crisis: An experimental simulation. Soc Psychol Q. 1988;51(2):123–40.CrossRef
32.
Boerma WG, Groenewegen PP, Van der Zee J. General practice in urban and rural Europe: the range of curative services. Soc Sci Med. 1998;47(4):445–53.CrossRefPubMed
Metadata
Title
The influential role of personal advice networks on general practitioners’ performance: a social capital perspective
Authors
Stefano Calciolari
Laura G. González-Ortiz
Federico Lega
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2017
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-017-2467-x

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