Cooperation Improvement in an Integrated Healthcare Network: A Social Network Analysis

Nicolás Larrain; Sophie Wang; Tom Stargardt; Oliver Groene

doi:10.5334/ijic.6519

Cooperation Improvement in an Integrated Healthcare Network: A Social Network Analysis

Int J Integr Care. 2023 Jun 26;23(2):32. doi: 10.5334/ijic.6519. eCollection 2023 Apr-Jun.

Authors

Nicolás Larrain^{1

2}, Sophie Wang^{1

2}, Tom Stargardt², Oliver Groene^{1

3}

Affiliations

¹ OptiMedis AG, Hamburg, DE.
² Hamburg Centre for Health Economics (HCHE), University of Hamburg, Hamburg, DE.
³ University of Witten/Herdecke, Witten, DE.

Abstract

Background: Cooperation is a core feature of integrated healthcare systems and an important link in their value-creating mechanism. The premise is that providers who cooperate can promote more efficient use of health services while improving health outcomes. We studied the performance of an integrated healthcare system in improving regional cooperation.

Methods: Using claims data and social network analysis, we constructed the professional network from 2004 to 2017. Cooperation was studied by analyzing the evolution of network properties at network and physician practice (node) level. The impact of the integrated system was studied with a dynamic panel model that compared practices that participated in the integrated system versus nonparticipants.

Results: The regional network evolved favourably towards cooperation. Network density increased 1.4% on average per year, while mean distance decreased 0.78%. At the same time, practices participating in the integrated system became more cooperative compared to other practices in the region: Degree (1.64e-03, p = 0.07), eigenvector (3.27e-03, p = 0.06) and betweenness (4.56e-03, p < 0.001) centrality increased more for participating practices.

Discussion: Findings can be explained by the holistic approach to patients' care needs and coordination efforts of integrated healthcare. The paper provides a valuable design for performance assessment of professional cooperation.

Highlights: Using claims data and social network analysis, we identify a regional cooperation network and conduct a panel analysis to measure the impact of an integrated care initiative on enhancing professional cooperation.Physician practices participating in the integrated system became more cooperative and improved their influence in the regional network more than non-participating practices.Integrated healthcare systems effectively incentivize cooperation through a holistic approach to patient care needs and coordination efforts.

Keywords: Social Network Analysis; dynamic panel analysis; integrated healthcare systems; physician cooperation.

Grants and funding

This research project was funded by the Marie Sklodowska-Curie Innovative Training Network (HealthPros- Healthcare Performance Intelligence Professionals; https://www.healthpros-h2020.eu/), project of the European Union’s Horizon 2020 research and innovation program under grant agreement no. 765141. The funder (EU) provided support through OptiMedis AG in the form of salaries for NL and SW during the study, but did not have any role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are further articulated in the ‘author contributions’ section. The views expressed in this manuscript are those of the authors and not necessarily those of the EU.