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Geographic variation in the cost of ambulatory care in Switzerland


Busato, André; Matter, Pius; Künzi, Beat; Goodman, David (2012). Geographic variation in the cost of ambulatory care in Switzerland. Journal of Health Services Research & Policy, 17(1):18-23.

Abstract

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.

Citations

2 citations in Web of Science®
3 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Institute of General Practice
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2012
Deposited On:03 Apr 2012 06:47
Last Modified:05 Apr 2016 15:35
Publisher:Royal Society of Medicine Press
ISSN:1355-8196
Publisher DOI:10.1258/jhsrp.2011.010056
PubMed ID:22008711

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