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Relational capital in referrer networks of medical specialists in office settings

Nina Sophie Pflugfelder (Forschungsprofessur Peter Pawlowsky: Team- und Wissensmanagement, TU Chemnitz, Chemnitz, Germany)
Frank Ng (Central Research Institute of Ambulatory Health Care in the Federal Republic of Germany (Zi), Berlin, Germany)

Journal of Intellectual Capital

ISSN: 1469-1930

Article publication date: 20 April 2022

Issue publication date: 28 April 2023




The purpose of this article is to explore the association of the Relational Capital (RC) embedded in a medical specialist’s social–professional network with the specialist’s economic performance based on social network analysis (SNA).


Using health insurance claims data regarding ∼108,000 physicians treating ∼72,000,000 patients, social–professional networks (patient-sharing-networks (PSNs)) of ∼26,000 medical specialists were simulated. To explore the correlation of the network's characteristics (degree centrality, density, relative betweenness centrality and referrer concentration) with economic performance, ordinary-least-squares (OLS)-regression models were estimated for ten common specialties (gynecology, internal medicine, orthopedics, ophthalmology, otolaryngology, dermatology, urology, neurology, radiology and rehabilitative medicine).


The study confirms the applicability and strong explanatory power of SNA metrics for RC measurement in ambulatory healthcare. Degree centrality and relative betweenness centrality correlate positively with economic performance, whereas density and referrer concentration exhibit negative coefficients. These results confirm the argument that RC has a strong association with the economic performance of medical specialists.


The study pioneers SNA for RC measurement in healthcare. It is among the first publications on specialists' PSNs. Questions for future research are proposed.



The authors are grateful to N.P.’s PhD supervisor Prof. Peter Pawlowsky for his guidance throughout this project and to the Board of Central Research Institute of Ambulatory Health Care for providing access to the data used in this study. Furthermore, the authors would like to thank Dr. Mandy Schulz for her encouragement and constructive criticism of our work.

Conflicts of interests: The Central Research Institute of Ambulatory Health Care provided the data for this study and is the employer of second author F.N. The Institute is sponsored by the regional and federal Kassenärztliche Vereinigungen of Germany. Apart from that, the authors have no relevant financial or non-financial interests to disclose.


Pflugfelder, N.S. and Ng, F. (2023), "Relational capital in referrer networks of medical specialists in office settings", Journal of Intellectual Capital, Vol. 24 No. 3, pp. 710-729.



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