Physicians’ non-adherence to clinical care guidelines has been observed for many health conditions, and has particularly damaging repercussions for both HIV-infected patients’ health and for policies to reduce the domestic HIV epidemic. This paper investigates the role of physician networks in promoting quality (more adherent) HIV care for publicly insured patients in California between 2007 and 2010. I identify physician peers through shared patients and develop repeated observations of medication regimen and disease monitoring quality across physicians and patients. Using the structure of physician networks to create instrumental variables, I find heterogeneous effects across peer types. Generalist peers have no effect on medication decisions, but a one percent improvement in HIV specialist peers’ medication regimen quality increases generalists’ medication regimen quality by 0.15 percent. Using social network statistics that describe a physician’s relative network position, I find that increased collaboration among physicians of both types is the only significant network contributor to higher quality disease monitoring. Simulations show that improving generalists’ network connections to specialists could provide adherent medication regimens to an additional 2,779 patients in California in 2010, reducing the annual number of new infections by 5 percent. These findings illustrate the potential for network connections to diffuse complex treatment protocols and suggest specific mechanisms for reducing the HIV epidemic, which is disproportionately burdening underrepresented demographic communities in the U.S.
Friday, April 13, 2018
3:30pm – 5:00pm
Small reception to follow in Room 426. All are invited to attend.