Health Care Utilization and Expenditures in Persons Receiving Social Assistance in 2012 Evidence From Switzerland

Abstract

Introduction:Lower socioeconomic position and measures of social and material deprivation are associated with morbidity and mortality. These inequalities in health among groups of various statuses remain one of the main challenges for public health. The aim of the study was to investigate differences in health care use and costs between recipients of social assistance and non-recipients aged 65 years and younger within the Swiss healthcare system.Methods:We analyzed claims data of 13 492 individuals living in Bern, Switzerland of which 391 received social assistance. For the year 2012, we compared the number of physician visits, hospitalizations, prescribed drugs, and total health care costs as covered by mandatory health insurance. Linear and logistic adjusted regression analyses were made to estimate the effect of receipt of social assistance on health service use and costs.Results:Multivariate linear regression analysis revealed that health care costs increased on average by 1 666 CHF if individuals received social assistance. Recipients of social assistance had on average 1.2 more ambulatory consultations than non-recipients and got 1.65 more different medications prescribed as compared to non-recipients. The chance for recipients of social assistance to be hospitalized was almost twice that of non-recipients (Odds Ratio 1.96, 95% confidence interval 1.49-2.59).Conclusions:Recipients of social assistance demonstrate an exceedingly high use of health services. The need for interventions to alleviate the identified inequalities in health and health care needs is obvious.

Death at no cost? Persons with no health insurance claims in the last year of life in Switzerland

“…Being male, younger, healthier, and living alone was also found to be associated with higher failure to pay insurance premiums in Switzerland [ 19 ], and could partly support our findings of either delayed healthcare or lack of healthcare needs in groups with these attributes. Reich et al showed that persons of lower socioeconomic status, who receive social assistance, generally have higher intensity and cost of healthcare [ 20 ], which parallels our weak association of no HIC among individuals from high Swiss-SEP regions. Similarly as in the case of mortality, the use of ecological instead of individual SEP may be a reason for weaker association [ 17 ].…”

“…Similarly as in the case of mortality, the use of ecological instead of individual SEP may be a reason for weaker association [ 17 ]. The Reich et al study also identified higher rates of social assistance among those suffering from psychological disorders and psychoses (identified using pharmaceutical cost groups) [ 20 ], which supports the idea that these groups might be more economically vulnerable. Mental illness has been associated with problems in paying medical bills [ 21 ] and forgone medical and prescription care [ 22 ], and these findings parallel results of this study.…”

Experiences of Antenatal Care Among Women Who Are Socioeconomically Deprived in High‐Income Industrialized Countries: An Integrative Review

“…The disparity in health care expenditure between adult women with and without social welfare was greatest in younger women. The study, unfortunately, did not identify costs related to maternity care . There is growing evidence that health care in high‐income countries has been affected by the economic downturn.…”

Injections frequency and health care costs in patients treated with aflibercept compared to ranibizumab: new real-life evidence from Switzerland

“…Supplementary hospital insurance in Switzerland is purchased, if individuals wish further comfort of a semiprivate or private ward or treatment in another canton for personal reasons. Currently, there are 57 insurance companies providing basic health coverage in Switzerland., They offer a range of different premiums and types of health plans from which Swiss residents are free to choose among them managed care health plans [ 12 ].…”