Effect of hospital referral networks on patient readmissions

Daniele Mascia*, Federica Angeli, Fausto Di Vincenzo

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Previous studies have shown that referral networks encompass important mechanisms of coordination and integration among hospitals, which enhance numerous organizational-level benefits, such as productivity, efficiency, and quality of care. The present study advances previous research by demonstrating how hospital referral networks influence patient readmissions. Data include 360,697 hospitalization events within a regional community of hospitals in the Italian National Health Service. Multilevel hierarchical regression analysis tests the impacts of referral networks' structural characteristics on patient hospital readmissions. The results demonstrate that organizational centrality in the overall referral network and ego-network density have opposing effects on the likelihood of readmission events within hospitals; greater centrality is negatively associated with readmissions, whereas greater ego-network density increases the likelihood of readmission events. Our findings support the (re)organization of healthcare systems and provide important indications for policymakers and practitioners.

Original languageEnglish
Pages (from-to)113-121
Number of pages9
JournalSocial science and medicine
Early online date14 Mar 2015
Publication statusPublished - 1 May 2015


  • Hierarchical linear modeling
  • Interorganizational collaboration
  • Patient readmission
  • Social network analysis

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