| Title |
Death at no cost? Persons with no health insurance claims in the last year of life in Switzerland
|
|---|---|
| Published in |
BMC Health Services Research, March 2018
|
| DOI | 10.1186/s12913-018-2984-2 |
| Pubmed ID | |
| Authors |
Radoslaw Panczak, Viktor von Wyl, Oliver Reich, Xhyljeta Luta, Maud Maessen, Andreas E. Stuck, Claudia Berlin, Kurt Schmidlin, David C. Goodman, Matthias Egger, Kerri Clough-Gorr, Marcel Zwahlen |
| Abstract |
Lack of health insurance claims (HIC) in the last year of life might indicate suboptimal end-of-life care, but reasons for no HIC are not fully understood because information on causes of death is often missing. We investigated association of no HIC with characteristics of individuals and their place of residence. We analysed HIC of persons who died between 2008 and 2010, which were obtained from six providers of mandatory Swiss health insurance. We probabilistically linked these persons to death certificates to get cause of death information and analysed data using sex-stratified, multivariable logistic regression. Supplementary analyses looked at selected subgroups of persons according to the primary cause of death. The study population included 113,277 persons (46% males). Among these persons, 1199 (proportion 0.022, 95% CI: 0.021-0.024) males and 803 (0.013, 95% CI: 0.012-0.014) females had no HIC during the last year of life. We found sociodemographic and health differentials in the lack of HIC at the last year of life among these 2002 persons. The likelihood of having no HIC decreased steeply with older age. Those who died of cancer were more likely to have HIC (adjusted odds ratio for males 0.17, 95% CI: 0.13-0.22; females 0.19, 95% CI: 0.12-0.28) whereas those dying of mental and behavioural disorders (AOR males 1.83, 95% CI:1.42-2.37; females 1.65, 95% CI: 1.27-2.14), and males dying of suicide (AOR 2.15, 95% CI: 1.72-2.69) and accidents (AOR 2.41, 95% CI: 1.96-2.97) were more likely to have none. Single, widowed, and divorced persons also were more likely to have no HIC (AORs in range of 1.29-1.80). There was little or no association between the lack of HIC and characteristics of region of residence. Patterns of no HIC differed across main causes of death. Associations with age and civil status differed in particular for persons who died of cancer, suicide, accidents and assaults, and mental and behavioural disorders. Particular groups might be more likely to not seek care or not report health insurance costs to insurers. Researchers should be aware of this aspect of health insurance data and account for persons who lack HIC. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 44 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 44 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 11 | 25% |
| Professor > Associate Professor | 4 | 9% |
| Professor | 4 | 9% |
| Student > Master | 4 | 9% |
| Student > Ph. D. Student | 3 | 7% |
| Other | 10 | 23% |
| Unknown | 8 | 18% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 14 | 32% |
| Nursing and Health Professions | 10 | 23% |
| Economics, Econometrics and Finance | 4 | 9% |
| Psychology | 2 | 5% |
| Social Sciences | 2 | 5% |
| Other | 3 | 7% |
| Unknown | 9 | 20% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 28 August 2018.
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#20,469,520
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Outputs from BMC Health Services Research
#7,176
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#294,860
of 333,763 outputs
Outputs of similar age from BMC Health Services Research
#198
of 217 outputs
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