Price sensitivity and demand for healthcare services: Investigating demand-side financial incentives using anonymised claims data from Switzerland

Project description

Compulsory healthcare insurance in Switzerland entails a deductible system. The fact that the insuree pays only a small amount of health care expenses as soon as the deductible is reached, or none at all after the maximum co-payment, could create an incentive to use services that are not beneficial in the individual context and thus lead to unnecessary consumption of resources. In addition, or alternatively, beneficial healthcare consumption from the upcoming calendar year might be «shifted» to the current calendar year to avoid paying for these services in the next calendar year. Supply side structures, such as a relatively high density of service providers in a certain area, could reinforce or facilitate this effect by providing easier access to healthcare services. 

The objective of this research project is to identify and quantify the overuse of healthcare services by insurees who exceeded the annual deductible and completed their co-payment. Additionally, we aim at exploring the extent to which such overuse of healthcare services is mediated by structures on the supply-side, e.g., as measured by physician density.

This study will present two core contributions. The first is to quantify the demand-side induced overconsumption of healthcare services as influenced by exceeding the deductible and the subsequent co-payment in Switzerland. The second is to isolate the effect of supply structures as mediators of such overconsumption. Ultimately, our results can be used to suggest how the deductible and co-payment system could be modified to avoid unnecessary use of healthcare resources. In the end, decreasing demand-side induced LVC will help to redistribute healthcare resources to patients in real need for care.

Project team

Irene SalviJohannes CordierDr. Justus VogelDr. David KuklinskiProf. Dr. Alexander Geissler

Cooperation partner

Groupe Mutuel Services AG

Funding source

Groupe Mutuel Services AG

Duration

2023 

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