Identifying and Measuring Knowledge Spillovers of Health Service Delivery Interventions: A Network Analysis Approach

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Health care policies may have effects other than those originally intended by policy makers. These unintended effects are called spillovers. For example, a financial penalty policy intended to reduce readmission rates for acute myocardial infarction, heart failure, and pneumonia in the US Medicare was associated with reductions in readmission rates for conditions that were not targeted by the policy. Although the existence of such spillover effects is increasingly being recognised, there is a lack of understanding of how these spillover effects occur.In health care, an important mechanism is the exchange of knowledge between health care professionals. Analyses of spillovers between health care professionals used to be very costly because they required a detailed mapping of the social network that could only be generated by research based on qualitative interviews and questionnaires. However, it has recently been found that social networks can accurately inferred from administrative data sources alone. The aim of this research is to use these new methods to 1) construct social networks between health care professionals, 2) to describe the networks in terms of how closely related the network members are, and in terms of the characteristics of the members, 3) to measure the size of spillovers in two examples, and determine how the shape and size of the network and the relations between its members affect spillover effects. The existence of spillovers can mean that the effect of health care policies is measured incorrectly. The last part of the project will consider how information about networks between health care professionals can be used to measure the effect of new policies more accurately.