OBJECTIVES: Swiss health care is relatively costly. In order better to understand the drivers of spending, this study analyses geographic variation in per capita consultation costs for ambulatory care. METHODS: Small area and longitudinal analysis of costs of ambulatory services covered by compulsory health insurance, 2003-07. RESULTS: The results show considerable geographic variation in per capita consultation costs, with higher costs in urban compared to rural areas. Areas with higher availability of care had higher costs, and residents of urban and high income areas used more specialist care and generated higher costs than residents of rural areas. CONCLUSIONS: There are persistent regional differences in the per capita cost of ambulatory care that are not explained by demographic factors, access to care, or needs. It is likely that higher access to care leads to greater inappropriate use, particularly of specialists. Implementing gatekeeping systems and financial incentives that encourage better coordination of primary care may slow growth in costs and improve care.
OBJECTIVES: Swiss health care is relatively costly. In order better to understand the drivers of spending, this study analyses geographic variation in per capita consultation costs for ambulatory care. METHODS: Small area and longitudinal analysis of costs of ambulatory services covered by compulsory health insurance, 2003-07. RESULTS: The results show considerable geographic variation in per capita consultation costs, with higher costs in urban compared to rural areas. Areas with higher availability of care had higher costs, and residents of urban and high income areas used more specialist care and generated higher costs than residents of rural areas. CONCLUSIONS: There are persistent regional differences in the per capita cost of ambulatory care that are not explained by demographic factors, access to care, or needs. It is likely that higher access to care leads to greater inappropriate use, particularly of specialists. Implementing gatekeeping systems and financial incentives that encourage better coordination of primary care may slow growth in costs and improve care.
Authors: Wolfram J Herrmann; Alexander Haarmann; Uwe Flick; Anders Bærheim; Thomas Lichte; Markus Herrmann Journal: BMJ Open Date: 2013-06-20 Impact factor: 2.692
Authors: Michael Mehring; Ewan Donnachie; Antonius Schneider; Martin Tauscher; Roman Gerlach; Constanze Storr; Klaus Linde; Andreas Mielck; Werner Maier Journal: BMJ Open Date: 2017-10-22 Impact factor: 2.692
Authors: Xhyljeta Luta; Christophe Bagnoud; Mark Lambiris; Anne Decollogny; Yves Eggli; Marie-Annick Le Pogam; Pedro Marques-Vidal; Joachim Marti Journal: BMJ Open Date: 2020-01-06 Impact factor: 2.692
Authors: Kevin Migliazza; Caroline Bähler; Daniel Liedtke; Andri Signorell; Stefan Boes; Eva Blozik Journal: BMC Health Serv Res Date: 2021-05-28 Impact factor: 2.655