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Research & theory

An empirical investigation of the efficiency effects of integrated care models in Switzerland

Authors:

Oliver Reich ,

Department of Public Health and Health Technology Assessment, UMIT - University of Health Sciences, Medical Informatics and Technology, Eduard Wallnöfer Zentrum 1, A-6060 Hall in Tyrol, Austria, AT
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Roland Rapold,

Division of Health Economics and Health Policy, Helsana, Zürichstrasse 130, CH-8600 Dübendorf, Switzerland, CH
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Magdalena Thöni

Department of Public Health and Health Technology Assessment, UMIT - University of Health Sciences, Medical Informatics and Technology, Eduard Wallnöfer Zentrum 1, A-6060 Hall in Tyrol, Austria, AT
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Abstract

Introduction: This study investigates the efficiency gains of integrated care models in Switzerland, since these models are regarded as cost containment options in national social health insurance. These plans generate much lower average health care expenditure than the basic insurance plan. The question is, however, to what extent these total savings are due to the effects of selection and efficiency.

Methods: The empirical analysis is based on data from 399,274 Swiss residents that constantly had compulsory health insurance with the Helsana Group, the largest health insurer in Switzerland, covering the years 2006 to 2009. In order to evaluate the efficiency of the different integrated care models, we apply an econometric approach with a mixed-effects model.

Results: Our estimations indicate that the efficiency effects of integrated care models on health care expenditure are significant. However, the different insurance plans vary, revealing the following efficiency gains per model: contracted capitated model 21.2%, contracted non-capitated model 15.5% and telemedicine model 3.7%. The remaining 8.5%, 5.6% and 22.5% respectively of the variation in total health care expenditure can be attributed to the effects of selection.

Conclusions: Integrated care models have the potential to improve care for patients with chronic diseases and concurrently have a positive impact on health care expenditure. We suggest policy makers improve the incentives for patients with chronic diseases within the existing regulations providing further potential for cost-efficiency of medical care.

How to Cite: Reich O, Rapold R, Thöni M. An empirical investigation of the efficiency effects of integrated care models in Switzerland. International Journal of Integrated Care. 2012;12(1):None. DOI: http://doi.org/10.5334/ijic.685
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Published on 13 Jan 2012.
Peer Reviewed

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