Exploring the disparities of regional health care expenditures in Switzerland: some empirical evidence

Reich, Oliver; Weins, Cornelia; Schusterschitz, Claudia; Thöni, Magdalena

doi:10.1007/s10198-011-0299-x

Cited by 56 publications

(49 citation statements)

References 20 publications

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“…For example, international level approaches include [13,17] showing that both income levels and the structure of health care financing are relevant health expenditure variables. Similar results have also been discussed at a regional health care expenditure level [8,20,28,30,22,7,11].…”

Section: Review Of the Literaturesupporting

confidence: 71%

“…This finding is not inconsistent with the literature, however, as there are examples of both positive and negative signs for income in health expenditure equations with a comparable set of additional covariates, see e.g. [17,7] for a positive and significant relationship, [30] for a significantly negative sign and [8] for an insignificant relationship.…”

Section: Does Managed Care Affect Expenditure On Medication?contrasting

confidence: 39%

“…In particular, data on total (statutory) health care expenditure need to be made available by sickness funds, provider organizations or federal offices at the regional level in order to control for cost-shifting tendencies. The example of other countries such as Switzerland [30] proves that similar data bases can be well realized at a regional level. If so, further research may benefit from longer observation periods such that long term (financial) effects of managed care programs in Germany may be studied, too.…”

Section: Resultsmentioning

confidence: 97%

“…3 Note that [30] include the proportion of health maintenance organizations and family doctor models as an explanatory variable for regional health care expenditure in Switzerland. [15] including rough indicators such as the number of hospitalizations.…”

Section: Introductionmentioning

confidence: 99%

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Cost Containment and Managed Care: Evidence from German Macro Data

2013

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Standard-Nutzungsbedingungen:Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden.Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen.Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. Terms of use: Documents in AbstractThe major German health care reforms undertaken since the late 1990s resulted in the adoption of selective contracting mechanisms in a formerly sectorally separated health care system. These reforms marked the launch of managed care in Germany that is expected to yield both a higher quality of care and cost containment. We investigate if managed care had an influence on the structure of health care expenditure in Germany during the start-up phase of managed care from 2004 to 2008. We focus on pharmaceutical spending by statutory sickness funds (i.e. German lawenforced health insurance). We followed a macroeconomic evaluation approach based on a regional panel data set in contrast to previous research and were thus able to control for a comprehensive set of regional and demographic variables. We discuss alternative model specifications and include a range of sensitivity analyses. Our results suggest that in contrast to public perception the share of managed care contracts has a positive impact on pharmaceutical spending.

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Section: Review Of the Literaturesupporting

confidence: 71%

Section: Does Managed Care Affect Expenditure On Medication?contrasting

confidence: 39%

Section: Resultsmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

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Cost Containment and Managed Care: Evidence from German Macro Data

2013

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“…For the most expensive treatment (non-invasive specialists) they find significant lower costs for the prescription only case. Reich, Weins, Schusterschitz, and Thöni (2012) show that an increase in the dispensing doctors' density leads to an increase in per capita health care expenditure.…”

Section: General Overviewmentioning

confidence: 99%

Ask Your Doctor or Pharmacist! On the Effect of Self-Dispensing Physicians on Pharmaceutical Coverage

Bannert

Iselin

2015

SSRN Journal

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Standard-Nutzungsbedingungen:Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden.Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen.Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. Terms of use: Documents in AbstractIn most developed countries drugs are dispensed to patients through physicians and pharmacists. This paper studies the effects of allowing doctors to directly dispense drugs to patients (self-dispensation) on pharmaceutical coverage. We use a Swiss dataset in our empirical analysis because Switzerland's federalist legislation allows us to study self-dispensing and non-self-dispensing regimes alike. We add location information obtained from Google Geocoding services to our dataset in order to measure coverage based on distances. To capture a driver of long term positioning decisions, we take revenues as a proxy for a pharmacy's usage rate.We find that, ceteris paribus, self-dispensation leads to a lowered regional density of pharmacies. By matching similar pharmacies across both regimes we find that revenues are substantially lower for pharmacies under a self-dispensation regime.Pharmacies in cantons that allow physicians to dispense drugs tend to have relatively higher revenues associated with non-drugs. We suggest to organize legislation on self-dispensation at a fine grained regional level as regional typologies are the most reasonable justification for regime choice.

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Regional Variation in the Utilisation of Ambulatory Services in Germany

Kopetsch¹,

Schmitz

2013

Health Econ.

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We used an administrative dataset covering approximately 90% of all Germans to investigate the determinants of regional differences in the utilisation of ambulatory services in the year 2008. There are great regional differences in Germany, in GP, specialist and psychotherapist consultations. By means of a regression model taking account of the spatial dependencies of the error terms, we can explain a considerable part of the variation in terms of differences in demography, health status and socio-economic features. In addition, we made use of data on pollutants, the supply of services and the number of hospital cases as explanatory variables, which all have a significant influence on utilisation but contribute considerably less to explaining the differences. Overall, we are in a position to explain 29-40% of the regional differences in ambulatory case numbers at the level of the 413 counties and 55-70% at the level of the 16 German states (Länder) by observable differences.

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Exploring the disparities of regional health care expenditures in Switzerland: some empirical evidence

Cited by 56 publications

References 20 publications

Cost Containment and Managed Care: Evidence from German Macro Data

Cost Containment and Managed Care: Evidence from German Macro Data

Ask Your Doctor or Pharmacist! On the Effect of Self-Dispensing Physicians on Pharmaceutical Coverage

Regional Variation in the Utilisation of Ambulatory Services in Germany

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