Potentially avoidable hospitalizations and socioeconomic status in Switzerland: A small area-level analysis.
Détails
Télécharger: 38096621.pdf (878.03 [Ko])
Etat: Public
Version: Final published version
Licence: CC BY 4.0
Etat: Public
Version: Final published version
Licence: CC BY 4.0
ID Serval
serval:BIB_6460746D9AB0
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Potentially avoidable hospitalizations and socioeconomic status in Switzerland: A small area-level analysis.
Périodique
Health policy
ISSN
1872-6054 (Electronic)
ISSN-L
0168-8510
Statut éditorial
Publié
Date de publication
01/2024
Peer-reviewed
Oui
Volume
139
Pages
104948
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Résumé
The Swiss healthcare system is well known for the quality of its healthcare and population health but also for its high cost, particularly regarding out-of-pocket expenses. We conduct the first national study on the association between socioeconomic status and access to community-based ambulatory care (CBAC). We analyze administrative and hospital discharge data at the small area level over a four-year time period (2014 - 2017). We develop a socioeconomic deprivation indicator and rely on a well-accepted indicator of potentially avoidable hospitalizations as a measure of access to CBAC. We estimate socioeconomic gradients at the national and cantonal levels with mixed effects models pooled over four years. We compare gradient estimates among specifications without control variables and those that include control variables for area geography and physician availability. We find that the most deprived area is associated with an excess of 2.80 potentially avoidable hospitalizations per 1,000 population (3.01 with control variables) compared to the least deprived area. We also find significant gradient variation across cantons with a difference of 5.40 (5.54 with control variables) between the smallest and largest canton gradients. Addressing broader social determinants of health, financial barriers to access, and strengthening CBAC services in targeted areas would likely reduce the observed gap.
Mots-clé
Humans, Switzerland, Social Class, Socioeconomic Factors, Hospitalization, Delivery of Health Care, Equity in access to community based ambulatory care, Potentially avoidable hospitalizations, Socioeconomic deprivation, Socioeconomic gradient
Pubmed
Open Access
Oui
Création de la notice
19/12/2023 8:35
Dernière modification de la notice
11/01/2024 7:21