ArticleBMC health services research2009
Factors related to treatment intensity in Swiss primary care.
Article in BMC health services research, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Regional Disparities in Domiciliary Dental-Care Utilization and Their Association with Pneumonia Mortality in Japan: An Ecological Study Using National Open Data.JMA journal · 2026Article
- Physician Induced Demand: The Empirical Evidence of Angiography for Suspected Coronary Artery Disease.Iranian journal of public health · 2024Article
- Hospitalizations for ambulatory care sensitive conditions as an indicator of access to primary care and excess of bed supply.BMC health services research · 2019Article
- A Scoping Review of Components of Physician-induced Demand for Designing a Conceptual Framework.Journal of preventive medicine and public health = Yebang Uihakhoe chi · 2019Article
- Catchments of general practice in different countries--a literature review.International journal of health geographics · 2014Review
- Supply sensitive services in Swiss ambulatory care: an analysis of basic health insurance records for 2003-2007.BMC health services research · 2010Article
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundQuestions about the existence of supplier-induced demand emerge repeatedly in discussions about governing Swiss health care. This study therefore aimed to evaluate the interrelationship between structural factors of supply and the volume of services that are provided by primary care physicians in Switzerland.
methodsThe study was designed as a cross-sectional investigation, based on the complete claims data from all Swiss health care insurers for the year 2004, which covered information from 6087 primary care physicians and 4.7 million patients. Utilization-based health service areas were constructed and used as spatial units to analyze effects of density of supply. Hierarchical linear models were applied to analyze the data.
resultsThe data showed that, within a service area, a higher density of primary care physicians was associated with higher mortality rates and specialist density but not with treatment intensity in primary care. Higher specialist density was weakly associated with higher mortality rates and with higher treatment intensity density of primary care physicians. Annual physician-level data indicate a disproportionate increase of supplied services irrespective of the size of the number of patients treated during the same year and, even in high volume practices, no rationing but a paradoxical inducement of consultations occurred. The results provide empirical evidence that higher densities of primary care physicians, specialists and the availability of out-patient hospital clinics in a given area are associated with higher volume of supplied services per patient in primary care practices. Analyses stratified by language regions showed differences that emphasize the effect of the cantonal based (fragmented) governance of Swiss health care.
conclusionThe study shows high volumes in Swiss primary care and provides evidence that the volume of supply is not driven by medical needs alone. Effects related to the competition for patients between primary care physicians, specialists and out-patient hospital clinics and an association with the system of reimbursing services on a fee-for-service basis can not be excluded.
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