Does targeted information impact consumers' preferences for value-based health insurance? Evidence from a survey experiment.

Objectives: Value-based insurance design (VBID) aims to direct consumers' preferences by incentivizing the use of high-value care and discouraging the use of low-value care. However, consumers often have limited knowledge of health insurance and the health insurance system, possibly distorting their preferences. In this study, we aim to investigate the impact of specific information treatments on consumers' preferences for VBID.

Are integrated care models associated with improved drug safety in Swiss primary care? an observational analysis using healthcare claims data.

Background: Integrated care models (ICMs) might be an effective strategy to improve patients' quality of care. The aim of this study was to compare different ICMs such as family-doctor models, and a standard care model (SCM) regarding patients' drug safety in Swiss primary care.

Methods: We performed an observational study using health insurance claims data from patients who were continuously enrolled in an ICM or in a SCM between 2020 and 2021.

Between Scylla and Charybdis?-Health insurance claims-data to monitor quality of service delivery in ophthalmology.

The seminal work of Wennberg and Gittelsohn in 1973 emphasised the importance of health information for informed decision-making. This led to the creation of the Dartmouth Health Atlas in 1996, which has become an important resource for monitoring health services in the USA. The Dartmouth Health Atlas research revealed the existence of variation in health care without benefit to patients, and the dependence of health care use on local resource supply.

Drink and drive? Understanding the dynamics of youth risk-taking.

We exploit a reduction in the minimum legal drinking age (MLDA) in New Zealand from 20 to 18 to study the dynamics of youth risk-taking. Using the universe of road accidents over 15 years and an event history approach, we find no evidence that lowering the drinking age increased alcohol-related accidents among teens. Complementary results of a cohort analysis suggest that reducing the drinking age even led to a short-term decline in risky driving among youths directly affected by the MLDA change but had no longer-run impacts on youth risky driving and drinking behaviors.

Bridging the gap: Experimental evidence on information provision and health insurance choices.

Previous research has shown that individuals do not always make rational decisions when selecting their health insurance, for example, due to the existence of information frictions or mental gaps. We study the effect of specific types of information provision for decision support on health plan choices and test their potential to improve decision quality by implementing a randomized laboratory experiment. We provide personalized and generic aids, differentiate between numerical and visual decision support, and provide one or two optional formats of personalized information.

Assessing the excess costs of the in-hospital adverse events covered by the AHRQ's Patient Safety Indicators in Switzerland.

There currently exists no comprehensive and up-to date overview on the financial impact of the different adverse events covered by the Patient Safety Indicators (PSIs) from the Agency for Healthcare Research and Quality. We conducted a retrospective case-control study using propensity score matching on a national administrative data set of 1 million inpatients in Switzerland to compare excess costs associated with 16 different adverse events both individually and on a nationally aggregated level. After matching 8,986 cases with adverse events across the investigated PSIs to 26,931 controls, we used regression analyses to determine the excess costs associated with the adverse events and to control for other cost-related influences.

Smoking trends and health equity in Switzerland between 1992 and 2017: dependence of smoking prevalence on educational level and social determinants.

Background: Switzerland ranks among the top three healthcare systems in the world with regards to healthcare access, suggesting a high degree of health equity. However, Switzerland has few preventive strategies against smoking abuse. The aim of this study is to clarify whether educational level and citizenship status have an influence on the prevalence of smoking in Switzerland and whether there is health inequity related to a lack of preventive strategies.

Initial prescriptions and medication switches of biological products: an analysis of prescription pathways and determinants in the Swiss healthcare setting.

Objectives: Biological products have contributed to extraordinary advances in disease treatments over the last decade. However, the cost-saving potential of imitator products, so-called biosimilars, is still under-researched in Switzerland. This study aims to assess biosimilars' prescriptions at treatment initiation and their determinants, as well as biological therapy switches.

Using exogenous organizational and regional hospital attributes to explain differences in case-mix adjusted hospital costs.

Diagnosis-related group (DRG) hospital reimbursement systems differentiate cases into cost-homogenous groups based on patient characteristics. However, exogenous organizational and regional factors can influence hospital costs beyond case-mix differences. Therefore, most countries using DRG systems incorporate adjustments for such factors into their reimbursement structure.

On the Relative Importance of Different Factors Explaining Health Plan Choices: Evidence From Mandatory Health Insurance in Switzerland.

Many factors influence health plan choices. Classical individual-level determinants include socioeconomic and health-related characteristics, and risk attitudes. However, little is known to what extent personality traits can determine insurance choices.

Opioid prescriptions after knee replacement: a retrospective study of pathways and prognostic factors in the Swiss healthcare setting.

Objectives: The optimal use of opioids after knee replacement (KR) remains to be determined, given the growing evidence that opioids are no more effective than other analgesics and that their adverse effects can impair quality of life. Therefore, the objective is to examine opioid prescriptions after KR.

Design: In this retrospective study, we used descriptive statistics and estimated the association of prognostic factors using generalised negative binomial models.

Identification and assessment of a comprehensive set of structural factors associated with hospital costs in Switzerland.

Structural factors can influence hospital costs beyond case-mix differences. However, accepted measures on how to distinguish hospitals with regard to cost-related organizational and regional differences are lacking in Switzerland. Therefore, the objective of this study was to identify and assess a comprehensive set of hospital attributes in relation to average case-mix adjusted costs of hospitals.

How value-based policy interventions influence price negotiations for new medicines: An experimental approach and initial evidence.

Background: Various forms of value-based pricing policies for new medicines have recently been introduced in OECD countries. While these initiatives are expected to have a positive impact on societal outcomes such as availability, affordability and value for money, scientific evidence on this impact is scarce due to confidential agreements.

Objective: We aimed to assess the impact of value-based policy interventions in price negotiations on patient benefit in an experimental setting.

External validation of EPIC's Risk of Unplanned Readmission model, the LACE+ index and SQLape as predictors of unplanned hospital readmissions: A monocentric, retrospective, diagnostic cohort study in Switzerland.

Introduction: Readmissions after an acute care hospitalization are relatively common, costly to the health care system, and are associated with significant burden for patients. As one way to reduce costs and simultaneously improve quality of care, hospital readmissions receive increasing interest from policy makers. It is only relatively recently that strategies were developed with the specific aim of reducing unplanned readmissions using prediction models to identify patients at risk.

Potentially inappropriate medications and medication combinations before, during and after hospitalizations: an analysis of pathways and determinants in the Swiss healthcare setting.

Background: A hospitalization phase represents a challenge to medication safety especially for multimorbid patients as acute medical needs might interact with pre-existing medications or evoke adverse drug effects. This project aimed to examine the prevalence and risk factors of potentially inappropriate medications (PIMs) and medication combinations (PIMCs) in the context of hospitalizations.

Methods: Analyses are based on claims data of patients (≥65 years) with basic mandatory health insurance at the Helsana Group, and on data from the Hirslanden Swiss Hospital Group.

Assessment of the introduction of DRG-based reimbursement in Switzerland: Evidence on the short-term effects on length of stay compliance in university hospitals.

The implementation of a nationwide diagnosis-related groups (DRG) reimbursement system in 2012 marked an important step in increasing the transparency and efficiency of hospital services in Switzerland. However, no clear evidence exists to date on the response of hospitals to the introduction of SwissDRG. Using administrative data on inpatient stays in Swiss university hospitals and the length of stay compliance (LOSC) as a measure of hospital performance, we find a significant short-term reduction in LOSC for hospitals that experienced a change from retrospective per diem to prospective DRG reimbursement, compared to hospitals with a prospective payment system already before 2012.

What explains the inequalities in health care utilization between immigrants and non-migrants in Switzerland?

Background: Inequalities in health care use between immigrants and non-migrants are an important issue in many countries, with potentially negative effects on population health and welfare. The aim of this study is to understand the factors that explain these inequalities in Switzerland, a country with one of the highest percentages of foreign-born population.

Methods: Using health survey data, we compare non-migrants to four immigrant groups, differentiating between first- and second-generation immigrants, and culturally different and similar immigrants.

Assessing social preferences in reimbursement negotiations for new Pharmaceuticals in Oncology: an experimental design to analyse willingness to pay and willingness to accept.

Background: Price negotiations for specialty pharmaceuticals take place in a complex market setting. The determination of the added value of new treatments and the related societal willingness to pay are of increasing importance in policy reform debates. From a behavioural economics perspective, potential cognitive biases and other-regarding concerns affecting outcomes of reimbursement negotiations are of interest.

The impact of reimbursement negotiations on cost and availability of new pharmaceuticals: evidence from an online experiment.

Background: The necessity to measure and reward "value for money" of new pharmaceuticals has become central in health policy debates, as much as the requirement to assess the "willingness to pay" for an additional, quality-adjusted life year (QALY). There is a clear need to understand the capacity of "value-based" pricing policies to impact societal goals, like timely access to new treatments, sustainable health budgets, or incentivizing research to improve patient outcomes. Not only the pricing mechanics, but also the process of value assessment and price negotiation are subject to reform demands.

Correction: Treatment and cost of pressure injury stage III or IV in four patients with spinal cord injury: the Basel Decubitus Concept.

[This corrects the article DOI: 10.1038/s41394-019-0173-0.].

Treatment and cost of pressure injury stage III or IV in four patients with spinal cord injury: the Basel Decubitus Concept.

Study Design: Retrospective chart analyses as part of a quality improvement project.

Objectives: To demonstrate treatment of pressure injury (PI) in patients with spinal cord injuries (SCI) and analyse costs using the "modified Basel Decubitus Concept".

Setting: Inpatient setting of a specialised acute care and rehabilitation clinic for SCI.

Validity of screening instruments for the detection of dementia and mild cognitive impairment in hospital inpatients: A systematic review of diagnostic accuracy studies.

Introduction: As the population ages, Alzheimer's disease and other subtypes of dementia are becoming increasingly prevalent. However, in recent years, diagnosis has often been delayed or not made at all. Thus, improving the rate of diagnosis has become an integral part of national dementia strategies.