Potentially avoidable hospitalizations and socioeconomic status in Switzerland: A small area-level analysis.

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State: Public
Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_6460746D9AB0
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Potentially avoidable hospitalizations and socioeconomic status in Switzerland: A small area-level analysis.
Journal
Health policy
Author(s)
Spycher J., Morisod K., Moschetti K., Le Pogam M.A., Peytremann-Bridevaux I., Bodenmann P., Cookson R., Rodwin V., Marti J.
ISSN
1872-6054 (Electronic)
ISSN-L
0168-8510
Publication state
Published
Issued date
01/2024
Peer-reviewed
Oui
Volume
139
Pages
104948
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
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.
Keywords
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
Yes
Create date
19/12/2023 9:35
Last modification date
11/01/2024 8:21
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