IDEAS home Printed from https://ideas.repec.org/a/spr/ijphth/v65y2020i6d10.1007_s00038-020-01428-w.html
   My bibliography  Save this article

Regional differences in healthcare costs at the end of life: an observational study using Swiss insurance claims data

Author

Listed:
  • Caroline Bähler

    (Helsana Insurance Group)

  • Roland Rapold

    (Helsana Insurance Group)

  • Andri Signorell

    (Helsana Insurance Group)

  • Oliver Reich

    (Helsana Insurance Group)

  • Radoslaw Panczak

    (The University of Queensland)

  • Eva Blozik

    (Helsana Insurance Group
    University Medical Centre Freiburg)

Abstract

Objectives We evaluated healthcare cost differences at the end of life (EOL) between language regions in Switzerland, accounting for a comprehensive set of variables, including treatment intensity. Methods We evaluated 9716 elderly who died in 2014 and were insured at Helsana Group, with data on final cause of death provided by the Swiss Federal Statistical Office. EOL healthcare costs and utilization, ≥ 1 ICU admission and 10 life-sustaining interventions (cardiac catheterization, cardiac assistance device implantation, pulmonary artery wedge monitoring, cardiopulmonary resuscitation, gastrostomy, blood transfusion, dialysis, mechanical ventilation, intravenous antibiotics, cancer chemotherapies) reimbursed by compulsory insurance were examined. Results Taking into consideration numerous variables, relative cost differences decreased from 1.27 (95% CI 1.19–1.34) to 1.06 (CI 1.02–1.11) between the French- and German-speaking regions, and from 1.12 (CI 1.03–1.22) to 1.08 (CI 1.02–1.14) between the Italian- and German-speaking regions, but standardized costs still differed. Contrary to individual factors, density of home-care nurses, treatment intensity, and length of inpatient stay explain a substantial part of these differences. Conclusions Both supply factors and health-service provision at the EOL vary between Swiss language regions and explain a substantial proportion of cost differences.

Suggested Citation

  • Caroline Bähler & Roland Rapold & Andri Signorell & Oliver Reich & Radoslaw Panczak & Eva Blozik, 2020. "Regional differences in healthcare costs at the end of life: an observational study using Swiss insurance claims data," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 65(6), pages 969-979, July.
  • Handle: RePEc:spr:ijphth:v:65:y:2020:i:6:d:10.1007_s00038-020-01428-w
    DOI: 10.1007/s00038-020-01428-w
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s00038-020-01428-w
    File Function: Abstract
    Download Restriction: Access to the full text of the articles in this series is restricted.

    File URL: https://libkey.io/10.1007/s00038-020-01428-w?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Aleksandra Torbica & Rosanna Tarricone & Michael Drummond, 2018. "Does the approach to economic evaluation in health care depend on culture, values, and institutional context?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(6), pages 769-774, July.
    2. Costa-Font, Joan & Jimenez-Martin, Sergi & Vilaplana, Cristina, 2018. "Does long-term care subsidization reduce hospital admissions and utilization?," Journal of Health Economics, Elsevier, vol. 58(C), pages 43-66.
    3. Ulrike Muench & Michael Simon & Raphaëlle-Ashley Guerbaai & Carlo Pietro & Andreas Zeller & Reto W. Kressig & Franziska Zúñiga, 2019. "Preventable hospitalizations from ambulatory care sensitive conditions in nursing homes: evidence from Switzerland," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 64(9), pages 1273-1281, December.
    4. Van den Heede, Koen & Van de Voorde, Carine, 2016. "Interventions to reduce emergency department utilisation: A review of reviews," Health Policy, Elsevier, vol. 120(12), pages 1337-1349.
    5. Polder, Johan J. & Barendregt, Jan J. & van Oers, Hans, 2006. "Health care costs in the last year of life--The Dutch experience," Social Science & Medicine, Elsevier, vol. 63(7), pages 1720-1731, October.
    6. Gielen, Birgit & Remacle, Anne & Mertens, Raf, 2010. "Patterns of health care use and expenditure during the last 6 months of life in Belgium: Differences between age categories in cancer and non-cancer patients," Health Policy, Elsevier, vol. 97(1), pages 53-61, September.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Brüngger, Beat & Bähler, Caroline & Schwenkglenks, Matthias & Ulyte, Agne & Dressel, Holger & von Wyl, Viktor & Gruebner, Oliver & Wei, Wenjia & Serra-Burriel, Miquel & Blozik, Eva, 2021. "Surgical procedures in inpatient versus outpatient settings and its potential impact on follow-up costs," Health Policy, Elsevier, vol. 125(10), pages 1351-1358.
    2. Aleksander Krasowski & Joachim Krois & Sebastian Paris & Adelheid Kuhlmey & Hendrik Meyer-Lueckel & Falk Schwendicke, 2021. "Costs for Statutorily Insured Dental Services in Older Germans 2012–2017," IJERPH, MDPI, vol. 18(12), pages 1-18, June.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Caroline Bähler & Roland Rapold & Andri Signorell & Oliver Reich & Radoslaw Panczak & Eva Blozik, 0. "Regional differences in healthcare costs at the end of life: an observational study using Swiss insurance claims data," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 0, pages 1-11.
    2. Hamblin, Richard & Minko, Nikolai & Shuker, Carl & Hill, Jennifer & Merry, Alan F., 2018. "What happens at the end of life? Using linked administrative health data to understand healthcare usage in the last year of life in New Zealand," Health Policy, Elsevier, vol. 122(7), pages 783-790.
    3. Audrey Tanguy-Melac & Dorian Verboux & Laurence Pestel & Anne Fagot-Campagna & Philippe Tuppin & Christelle Gastaldi-Ménager, 2021. "Evolution of health care utilization and expenditure during the year before death in 2015 among people with cancer: French snds-based cohort study," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(7), pages 1039-1052, September.
    4. Rolden, Herbert J.A. & van Bodegom, David & Westendorp, Rudi G.J., 2014. "Variation in the costs of dying and the role of different health services, socio-demographic characteristics, and preceding health care expenses," Social Science & Medicine, Elsevier, vol. 120(C), pages 110-117.
    5. Quitterie Roquebert & Jonathan Sicsic & Thomas Rapp, 2021. "Health measures and long-term care use in the European frail population," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(3), pages 405-423, April.
    6. Bakx, Pieter & Wouterse, Bram & van Doorslaer, Eddy & Wong, Albert, 2020. "Better off at home? Effects of nursing home eligibility on costs, hospitalizations and survival," Journal of Health Economics, Elsevier, vol. 73(C).
    7. Liang-Chung Huang & Wu-Fu Chung & Shih-Wei Liu & Jau-Ching Wu & Li-Fu Chen & Yu-Chun Chen, 2019. "Characteristics of Non-Emergent Visits in Emergency Departments: Profiles and Longitudinal Pattern Changes in Taiwan, 2000–2010," IJERPH, MDPI, vol. 16(11), pages 1-16, June.
    8. Schmidt, Henrike & Wild, Eva-Maria & Schreyögg, Jonas, 2021. "Explaining variation in health information seeking behaviour – Insights from a multilingual survey," Health Policy, Elsevier, vol. 125(5), pages 618-626.
    9. Moura, Ana, 2022. "Do subsidized nursing homes and home care teams reduce hospital bed-blocking? Evidence from Portugal," Journal of Health Economics, Elsevier, vol. 84(C).
    10. Costa-Font, Joan & Jiménez-Martín, Sergi & Vilaplana-Prieto, Cristina, 2022. "Do Public Caregiving Subsidies and Supports affect the Provision of Care and Transfers?," Journal of Health Economics, Elsevier, vol. 84(C).
    11. Chen, Wen-Yi, 2020. "The welfare effect of co-payment adjustments on emergency department visits in medical centers: Evidence from Taiwan," Health Policy, Elsevier, vol. 124(11), pages 1192-1199.
    12. Joan Costa-Font & Valentina Zigante, 2020. "Building ‘implicit partnerships’? Financial long-term care entitlements in Europe," Policy Sciences, Springer;Society of Policy Sciences, vol. 53(4), pages 697-712, December.
    13. Dröge, Patrik & Ruhnke, Thomas & Fischer-Rosinsky, Antje & Henschke, Cornelia & Keil, Thomas & Möckel, Martin & Günster, Christian & Slagman, Anna, 2023. "Patients pathways before and after treatments in emergency departments: A retrospective analysis of secondary data in Germany," Health Policy, Elsevier, vol. 138(C).
    14. Guangbo Ma & Kun Xu, 2022. "Value-Based Health Care: Long-Term Care Insurance for Out-of-Pocket Medical Expenses and Self-Rated Health," IJERPH, MDPI, vol. 20(1), pages 1-20, December.
    15. Miao Guo & Yang Li & Minghao Wu & Terence C. Cheng, 2024. "Services and Cash: How Long-term Care Insurance Benefit Design Affects Household Behavior in China," Papers 2024-13, Centre for Health Economics, Monash University.
    16. Vincenzo Atella & Valentina Conti, 2013. "The effect of age and time to death on health care expenditures: the Italian experience," CEIS Research Paper 267, Tor Vergata University, CEIS, revised 12 Nov 2013.
    17. Hollingsworth, Bruce & Ohinata, Asako & Picchio, Matteo & Walker, Ian, 2022. "Does It Matter Who Cares for You? The Effect of Substituting Informal with Formal Personal Care on the Care Recipients' Health," IZA Discussion Papers 15457, Institute of Labor Economics (IZA).
    18. Costa-Font, Joan & Zigante, Valentina, 2020. "Building ‘implicit partnerships’? Financial long-term care entitlements in Europe," LSE Research Online Documents on Economics 106099, London School of Economics and Political Science, LSE Library.
    19. Norén, Anna, 2020. "Sick of my parents? Consequences of parental ill health on adult children," Working Paper Series 2020:1, IFAU - Institute for Evaluation of Labour Market and Education Policy.
    20. Anne Høy Seemann Vestergaard & Lars Holger Ehlers & Mette Asbjoern Neergaard & Christian Fynbo Christiansen & Jan Brink Valentin & Søren Paaske Johnsen, 2023. "Healthcare Costs at the End of Life for Patients with Non-cancer Diseases and Cancer in Denmark," PharmacoEconomics - Open, Springer, vol. 7(5), pages 751-764, September.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:ijphth:v:65:y:2020:i:6:d:10.1007_s00038-020-01428-w. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.