ArticleMedical care2017
Regional Variation of Cost of Care in the Last 12 Months of Life in Switzerland: Small-area Analysis Using Insurance Claims Data.
Article in Medical care, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.
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Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Health Insurance Schemes and Their Influences on Healthcare Variation in Asian Countries: A Realist Review and Theory's Testing in Thailand.International journal of health policy and management · 2024Pooled it
- Impact of socioeconomic status on end-of-life costs: a systematic review and meta-analysis.BMC palliative care · 2020Pooled it
- Challenges and opportunities of psychological aging research.European journal of ageing · 2025Review
- Lifetime economic burden of hemophilia using a nationwide real-world healthcare data.PloS one · 2025Article
- Regional Variation in End-of-life Care Just Before Death Among the Oldest Old in Japan: A Descriptive Study.Journal of epidemiology · 2024Article
- End-of-life expenditure on health care for the older population: a scoping review.Health economics review · 2024Article
- Specialist Palliative Care and Health Care Costs at the End of Life.PharmacoEconomics - open · 2024Article
- Geographic variation in inpatient medical expenditure among older adults aged 75 years and above in Japan: a three-level multilevel analysis of nationwide data.Frontiers in public health · 2024Article
- Article
- Opioid prescriptions after knee replacement: a retrospective study of pathways and prognostic factors in the Swiss healthcare setting.BMJ open · 2023Article
- Geographical disparities in obesity prevalence: small-area analysis of the Chilean National Health Surveys.BMC public health · 2022Article
- How does regulating doctors' admissions affect health expenditures? Evidence from Switzerland.BMC health services research · 2022Article
- Social and Regional Factors Predict the Likelihood of Admission to a Nursing Home After Acute Hospital Stay in Older People With Chronic Health Conditions: A Multilevel Analysis Using Routinely Collected Hospital and Census Data in Switzerland.Frontiers in public health · 2022Article
- Evidence on the economic value of end-of-life and palliative care interventions: a narrative review of reviews.BMC palliative care · 2021Review
- Potentially inappropriate medications and medication combinations before, during and after hospitalizations: an analysis of pathways and determinants in the Swiss healthcare setting.BMC health services research · 2021Article
- Health and social behaviour through pandemic phases in Switzerland: Regional time-trends of the COVID-19 Social Monitor panel study.PloS one · 2021Article
- Evolution or Revolution? Recommendations to Improve the Swiss Health Data Framework.Frontiers in public health · 2021Article
- Degree of regional variation and effects of health insurance-related factors on the utilization of 24 diverse healthcare services - a cross-sectional study.BMC health services research · 2020Article
- Regional differences in healthcare costs at the end of life: an observational study using Swiss insurance claims data.International journal of public health · 2020Observational
- Regional variation in hospital care at the end-of-life of Dutch patients with lung cancer exists and is not correlated with primary and long-term care.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2020Article
Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHealth care spending increases sharply at the end of life. Little is known about variation of cost of end of life care between regions and the drivers of such variation. We studied small-area patterns of cost of care in the last year of life in Switzerland.
methodsWe used mandatory health insurance claims data of individuals who died between 2008 and 2010 to derive cost of care. We used multilevel regression models to estimate differences in costs across 564 regions of place of residence, nested within 71 hospital service areas. We examined to what extent variation was explained by characteristics of individuals and regions, including measures of health care supply.
resultsThe study population consisted of 113,277 individuals. The mean cost of care during last year of life was 32.5k (thousand) Swiss Francs per person (SD=33.2k). Cost differed substantially between regions after adjustment for patient age, sex, and cause of death. Variance was reduced by 52%-95% when we added individual and regional characteristics, with a strong effect of language region. Measures of supply of care did not show associations with costs. Remaining between and within hospital service area variations were most pronounced for older females and least for younger individuals.
conclusionsIn Switzerland, small-area analysis revealed variation of cost of care during the last year of life according to linguistic regions and unexplained regional differences for older women. Cultural factors contribute to the delivery and utilization of health care during the last months of life and should be considered by policy makers.
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