Health care renunciation for economic reasons in Switzerland.

Details

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State: Public
Version: author
Serval ID
serval:BIB_B940F76D6785
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Health care renunciation for economic reasons in Switzerland.
Journal
Swiss Medical Weekly
Author(s)
Wolff Hans, Gaspoz Jean-Michel, Guessous Idris
ISSN
1424-3997[electronic]
ISSN-L
0036-7672
Publication state
Published
Issued date
2011
Peer-reviewed
Oui
Volume
141
Pages
w13165 [5 p.]
Language
english
Notes
Texte intégral: http://www.smw.ch/content/smw-2011-13165/
Abstract
BACKGROUND: Most societies elaborate ways to contain increasing health care expenditures. In Switzerland out of pocket payments and cuts in the catalogue of reimbursed services are used as cost-containment measures. The aims of the study were to estimate the extent of health care renunciation for economic reasons and to identify associated factors. METHODS: A population-based cross-sectional survey (2008-2009) of a representative sample in the Canton of Geneva, Switzerland. Health care underuse, income level categories (<CHF 3000/month, 3000-4999, 5000-6999, 7000-9499, 9500-13 000, >13 000), education, occupation, insurance status and cardiovascular comorbidities were collected using self-rated questionnaires. RESULTS: 765 men and 814 women aged 35-74 years participated. 14.5% (229/1579) (95%CI 12.7-16.2) renounced health care for economic reasons. Among those who renounced (N = 229), 74% renounced dental care, 37% physician consultation (22% specialist, 15% general practitioner), 26% health devices, 13% medication, and 5% surgery. Income was negatively correlated with renouncement (r = -0.18, p <.0001). Each decrease in income level category provided a 48% increased risk of renouncing health care for economic reasons (OR 1.48, 1.31-1.65). This association remained when dental care was excluded from the definition of health care renunciation. CONCLUSIONS: In a region of Switzerland with a high cost of living, such as Geneva, socioeconomic status may influence the use of the health care system, and renunciation for economic reasons was not uncommon. More than 30% of the lowest income group renounced health care for economical reasons in the previous year. Health care underuse and renunciation may worsen the health status of a substantial part of society.
Keywords
Adult , Aged , Cardiovascular Diseases/etiology , Confidence Intervals , Cross-Sectional Studies , Deductibles and Coinsurance/economics , Deductibles and Coinsurance/legislation & jurisprudence* , Female , Financing, Personal/economics* , Health Services/utilization* , Humans , Male , Middle Aged , Risk Factors , Social Class , Switzerland
Pubmed
Web of science
Open Access
Yes
Create date
22/02/2011 13:22
Last modification date
20/08/2019 15:27
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