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Determinants of knowledge-sharing networks in primary care

Mascia, Daniele; Pallotti, Francesca; Dandi, Roberto

doi: 10.1097/HMR.0000000000000139

Background: Around the world, health reforms are increasingly fostering collaboration and integration among primary care physicians with the aim of facilitating knowledge sharing and evidence-informed decision-making. Although extant research on this topic is abundant, the evidence and results regarding social and organizational factors affecting the formation of knowledge-sharing networks in this setting are inconclusive.

Purpose: The aim of this article is to explore multiple theoretical mechanisms explaining the formation of knowledge-sharing networks among primary care physicians across relevant clinical areas.

Methodology/Approach: The data are collected from two local health authorities in the Italian National Health Service that are responsible for delivering primary care in two Italian regions. Exponential random graph models are used to test the hypotheses.

Findings: Our findings indicate that knowledge-sharing networks are highly correlated across clinical areas. In addition, knowledge-sharing networks are highly reciprocal and clustered. We also observe that formal models adopted to foster collaboration have remarkably different effects on the formation of knowledge networks, depending upon the diverse knowledge management approaches adopted in the surveyed local health authorities.

Practice Implications: Primary care organizations need to develop and implement knowledge management practices in order to help physicians in identifying knowledge domain experts as well as to support connections through formal groupings and incentives.

Daniele Mascia, PhD, is Assistant Professor of Organization and Management Theory, Università Cattolica del Sacro Cuore and ALTEMS (Graduate School of Health Economics and Management), Rome, Italy.

Francesca Pallotti, PhD, is Senior Lecturer in Economic Sociology, Centre for Business Network Analysis, University of Greenwich, London, United Kingdom.

Roberto Dandi, PhD, is Assistant Professor of Management, LUISS Guido Carli University, Rome, Italy. E-mail:

The authors have disclosed that they have no significant relationship with, or financial interest in, any commercial companies pertaining to this article.

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