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01.12.2012 | Research article | Ausgabe 1/2012 Open Access

BMC Health Services Research 1/2012

Explaining regional variations in health care utilization between Swiss cantons using panel econometric models

Zeitschrift:
BMC Health Services Research > Ausgabe 1/2012
Autor:
Paul A Camenzind
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1472-6963-12-62) contains supplementary material, which is available to authorized users.

Competing interests

The author declares that he has no competing interests.

Authors' contributions

PA. Camenzind carried out the conception and design of the study, performed the analysis of data and drafted prior versions of the article. He also read and approved the final version of the manuscript.

Abstract

Background

In spite of a detailed and nation-wide legislation frame, there exist large cantonal disparities in consumed quantities of health care services in Switzerland. In this study, the most important factors of influence causing these regional disparities are determined. The findings can also be productive for discussing the containment of health care consumption in other countries.

Methods

Based on the literature, relevant factors that cause geographic disparities of quantities and costs in western health care systems are identified. Using a selected set of these factors, individual panel econometric models are calculated to explain the variation of the utilization in each of the six largest health care service groups (general practitioners, specialist doctors, hospital inpatient, hospital outpatient, medication, and nursing homes) in Swiss mandatory health insurance (MHI). The main data source is 'Datenpool santésuisse', a database of Swiss health insurers.

Results

For all six health care service groups, significant factors influencing the utilization frequency over time and across cantons are found. A greater supply of service providers tends to have strong interrelations with per capita consumption of MHI services. On the demand side, older populations and higher population densities represent the clearest driving factors.

Conclusions

Strategies to contain consumption and costs in health care should include several elements. In the federalist Swiss system, the structure of regional health care supply seems to generate significant effects. However, the extent of driving factors on the demand side (e.g., social deprivation) or financing instruments (e.g., high deductibles) should also be considered.
Zusatzmaterial
Additional file 1: Appendix. Tables 4 and 5. (DOC 102 KB)
12913_2011_2017_MOESM1_ESM.DOC
Authors’ original file for figure 1
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