Institute of Economics and Business Administration, Albert-Ludwigs-University of Freiburg, Rempartstr. 16, 79098, Freiburg, Germany.
Health Care Manag Sci. 2022 Sep;25(3):498-514. doi: 10.1007/s10729-022-09595-3. Epub 2022 Jun 1.
The sharing of patients reflects collaborative relationships between various healthcare providers. Patient-sharing in the outpatient sector is influenced by both physicians' activities and patients' preferences. Consequently, a patient-sharing network arises from two distinct mechanisms: the initiative of the physicians on the one hand, and that of the patients on the other. We draw upon medical claims data to study the structure of one patient-sharing network by differentiating between these two mechanisms. Owing to the institutional requirements of certain healthcare systems rather following the Bismarck model, we explore different triadic patterns between general practitioners and medical specialists by applying exponential random graph models. Our findings imply deviation from institutional expectations and reveal structural realities visible in both networks.
患者共享反映了各种医疗保健提供者之间的协作关系。门诊部门的患者共享受到医生活动和患者偏好的双重影响。因此,患者共享网络由两种不同的机制产生:一方面是医生的主动性,另一方面是患者的主动性。我们利用医疗索赔数据,通过区分这两种机制来研究一个患者共享网络的结构。由于某些医疗保健系统的制度要求而不是遵循俾斯麦模式,我们通过应用指数随机图模型来探索普通科医生和医学专家之间的不同三元模式。我们的研究结果表明存在与制度预期的偏差,并揭示了两个网络中可见的结构现实。