11 results on '"Brüngger, Beat"'
Search Results
2. Degree of regional variation and effects of health insurance-related factors on the utilization of 24 diverse healthcare services - a cross-sectional study
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Wei, Wenjia, Ulyte, Agne, Gruebner, Oliver, von Wyl, Viktor, Dressel, Holger, Brüngger, Beat, Blozik, Eva, Bähler, Caroline, Braun, Julia, and Schwenkglenks, Matthias
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- 2020
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3. Going beyond the mean: economic benefits of myocardial infarction secondary prevention
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von Wyl, Viktor, Ulyte, Agne, Wei, Wenjia, Radovanovic, Dragana, Grübner, Oliver, Brüngger, Beat, Bähler, Caroline, Blozik, Eva, Dressel, Holger, and Schwenkglenks, Matthias
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- 2020
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4. Appropriateness of bone density measurement in Switzerland: a cross-sectional study
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Zechmann, Stefan, Scherz, Nathalie, Reich, Oliver, Brüngger, Beat, Senn, Oliver, Rosemann, Thomas, and Neuner-Jehle, Stefan
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- 2018
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5. Temporal trends and regional disparities in cancer screening utilization: an observational Swiss claims-based study
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Bähler, Caroline; https://orcid.org/0000-0002-4650-1463, Brüngger, Beat, Ulyte, Agne, Schwenkglenks, Matthias, von Wyl, Viktor; https://orcid.org/0000-0002-8754-9797, Dressel, Holger, Gruebner, Oliver, Wei, Wenjia, Blozik, Eva, Bähler, Caroline; https://orcid.org/0000-0002-4650-1463, Brüngger, Beat, Ulyte, Agne, Schwenkglenks, Matthias, von Wyl, Viktor; https://orcid.org/0000-0002-8754-9797, Dressel, Holger, Gruebner, Oliver, Wei, Wenjia, and Blozik, Eva
- Abstract
BACKGROUND: We examined colorectal, breast, and prostate cancer screening utilization in eligible populations within three data cross-sections, and identified factors potentially modifying cancer screening utilization in Swiss adults. METHODS: The study is based on health insurance claims data of the Helsana Group. The Helsana Group is one of the largest health insurers in Switzerland, insuring approximately 15% of the entire Swiss population across all regions and age groups. We assessed proportions of the eligible populations receiving colonoscopy/fecal occult blood testing (FOBT), mammography, or prostate-specific antigen (PSA) testing in the years 2014, 2016, and 2018, and calculated average marginal effects of individual, temporal, regional, insurance-, supply-, and system-related variables on testing utilization using logistic regression. RESULTS: Overall, 8.3% of the eligible population received colonoscopy/FOBT in 2014, 8.9% in 2016, and 9.2% in 2018. In these years, 20.9, 21.2, and 20.4% of the eligible female population received mammography, and 30.5, 31.1, and 31.8% of the eligible male population had PSA testing. Adjusted testing utilization varied little between 2014 and 2018; there was an increasing trend of 0.8% (0.6-1.0%) for colonoscopy/FOBT and of 0.5% (0.2-0.8%) for PSA testing, while mammography use decreased by 1.5% (1.2-1.7%). Generally, testing utilization was higher in French-speaking and Italian-speaking compared to German-speaking region for all screening types. Cantonal programs for breast cancer screening were associated with an increase of 7.1% in mammography utilization. In contrast, a high density of relevant specialist physicians showed null or even negative associations with screening utilization. CONCLUSIONS: Variation in cancer screening utilization was modest over time, but considerable between regions. Regional variation was highest for mammography use where recommendations are debated most controversially, and the implementation
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- 2021
6. Going beyond the mean: economic benefits of myocardial infarction secondary prevention
- Author
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von Wyl, Viktor; https://orcid.org/0000-0002-8754-9797, Ulyte, Agne, Wei, Wenjia, Radovanovic, Dragana, Grübner, Oliver, Brüngger, Beat, Bähler, Caroline, Blozik, Eva, Dressel, Holger, Schwenkglenks, Matthias, von Wyl, Viktor; https://orcid.org/0000-0002-8754-9797, Ulyte, Agne, Wei, Wenjia, Radovanovic, Dragana, Grübner, Oliver, Brüngger, Beat, Bähler, Caroline, Blozik, Eva, Dressel, Holger, and Schwenkglenks, Matthias
- Abstract
BACKGROUND: Using the example of secondary prophylaxis of myocardial infarction (MI), our aim was to establish a framework for assessing cost consequences of compliance with clinical guidelines; thereby taking cost trajectories and cost distributions into account. METHODS: Swiss mandatory health insurance claims from 1840 persons with hospitalization for MI in 2014 were analysed. Included persons were predominantly male (74%), had a median age of 73 years, and 71% were pre-exposed to drugs for secondary prophylaxis, prior to index hospitalization. Guideline compliance was defined as being prescribed recommended 4-class drug prophylaxis including drugs from the following four classes: beta-blockers, statins, aspirin or P2Y$_{12}$ inhibitors, and angiotension-converting enzyme inhibitors or angiotensin receptor blockers. Health care expenditures (HCE) accrued over 1 year after index hospitalization were compared by compliance status using two-part regression, trajectory analysis, and counterfactual decomposition analysis. RESULTS: Only 32% of persons received recommended 4-class prophylaxis. Compliant persons had lower HCE (- 4865 Swiss Francs [95% confidence interval - 8027; - 1703]) and were more likely to belong to the most favorable HCE trajectory (with 6245 Swiss Francs average annual HCE and comprising 78% of all studied persons). Distributional analyses showed that compliance-associated HCE reductions were more pronounced among persons with HCE above the median. CONCLUSIONS: Compliance with recommended prophylaxis was robustly associated with lower HCE and more favorable cost trajectories, but mainly among persons with high health care expenditures. The analysis framework is easily transferrable to other diseases and provides more comprehensive information on HCE consequences of non-compliance than mean-based regressions alone.
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- 2020
7. Degree of regional variation and effects of health insurance-related factors on the utilization of 24 diverse healthcare services - a cross-sectional study
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Wei, Wenjia; https://orcid.org/0000-0002-1977-8416, Ulyte, Agne, Gruebner, Oliver, von Wyl, Viktor; https://orcid.org/0000-0002-8754-9797, Dressel, Holger, Brüngger, Beat, Blozik, Eva, Bähler, Caroline, Braun, Julia, Schwenkglenks, Matthias, Wei, Wenjia; https://orcid.org/0000-0002-1977-8416, Ulyte, Agne, Gruebner, Oliver, von Wyl, Viktor; https://orcid.org/0000-0002-8754-9797, Dressel, Holger, Brüngger, Beat, Blozik, Eva, Bähler, Caroline, Braun, Julia, and Schwenkglenks, Matthias
- Abstract
BACKGROUND: Regional variation in healthcare utilization could reflect unequal access to care, which may lead to detrimental consequences to quality of care and costs. The aims of this study were to a) describe the degree of regional variation in utilization of 24 diverse healthcare services in eligible populations in Switzerland, and b) identify potential drivers, especially health insurance-related factors, and explore the consistency of their effects across the services. METHODS: We conducted a cross-sectional study using health insurance claims data for the year of 2014. The studied 24 healthcare services were predominantly outpatient services, ranging from screening to secondary prevention. For each service, a target population was identified based on applicable clinical recommendations, and outcome variable was the use of the service. Possible influencing factors included patients' socio-demographics, health insurance-related and clinical characteristics. For each service, we performed a comprehensive methodological approach including small area variation analysis, spatial autocorrelation analysis, and multilevel multivariable modelling using 106 mobilité spaciale regions as the higher level. We further calculated the median odds ratio in model residuals to assess the unexplained regional variation. RESULTS: Unadjusted utilization rates varied considerably across the 24 healthcare services, ranging from 3.5% (osteoporosis screening) to 76.1% (recommended thyroid disease screening sequence). The effects of health insurance-related characteristics were mostly consistent. A higher annual deductible level was mostly associated with lower utilization. Supplementary insurance, supplementary hospital insurance and having chosen a managed care model were associated with higher utilization of most services. Managed care models showed a tendency towards more recommended care. After adjusting for multiple influencing factors, the unexplained regional variation was genera
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- 2020
8. Appropriateness of bone density measurement in Switzerland: a cross-sectional study
- Author
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Zechmann, Stefan; https://orcid.org/0000-0001-5012-0068, Scherz, Nathalie, Reich, Oliver, Brüngger, Beat, Senn, Oliver, Rosemann, Thomas; https://orcid.org/0000-0002-6436-6306, Neuner-Jehle, Stefan, Zechmann, Stefan; https://orcid.org/0000-0001-5012-0068, Scherz, Nathalie, Reich, Oliver, Brüngger, Beat, Senn, Oliver, Rosemann, Thomas; https://orcid.org/0000-0002-6436-6306, and Neuner-Jehle, Stefan
- Abstract
BACKGROUND According to the WHO, osteoporosis is one of the most important non- communicable diseases worldwide. Different screening procedures are controversially discussed, especially concerning the concomitant issues of overdiagnosis and harm caused by inappropriate Dual X-ray Absorptiometry (DXA). The aim of this study was to evaluate the frequency and appropriateness of DXA as screening measure in Switzerland considering individual risk factors and to evaluate covariates independently associated with potentially inappropriate DXA screening. METHODS Retrospective cross-sectional study using insurance claim data of 2013. Among all patients with DXA screening, women < 65 and men < 70 years without osteoporosis or risk factors for osteoporosis were defined as receiving potentially inappropriate DXA. Statistics included descriptive measures and multivariable regressions to estimate associations of relevant covariates with potentially inappropriate DXA screening. RESULTS Of 1,131,092 patients, 552,973 were eligible. Among those 2637 of 10,000 (26.4%) underwent potentially inappropriate DXA screening. Female sex (Odds ratio 6.47, CI 6.41-6.54) and higher age showed the strongest association with any DXA screening. Female gender (Odds ratio 1.84, CI 1.49-2.26) and an income among the highest 5% (Odds ratio 1.40, CI 1.01-1.98) were significantly positively associated with potentially inappropriate DXA screening, number of chronic conditions (Odds ratio 0.67, CI 0.65-0.70) and living in the central region of Switzerland (Odds ratio 0.67, CI 0.48-0.95) negatively. CONCLUSION One out of four DXAs for screening purpose is potentially inappropriate. Stakeholders of osteoporosis screening campaigns should focus on providing more detailed information on appropriateness of DXA screening indications (e.g. age thresholds) in order to avoid DXA overuse.
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- 2018
9. Trends in prevalence, mortality, health care utilization and health care costs of Swiss IBD patients: a claims data based study of the years 2010, 2012 and 2014.
- Author
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Bähler, Caroline, Vavricka, Stephan R., Schoepfer, Alain M., Brüngger, Beat, and Reich, Oliver
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INFLAMMATORY bowel diseases ,MORTALITY ,DISEASE prevalence ,MEDICAL care costs ,PUBLIC health - Abstract
Background: Real-life data on inflammatory bowel disease (IBD) prevalence and costs are scarce. The aims of this study were to provide an overview of the prevalence, mortality, health care utilization and costs of IBD patients in Switzerland in the years 2010, 2012, and 2014.Methods: Based on claims data of the Helsana-Group, prevalence of IBD was assessed for 2010, 2012 and 2014. Mortality rates, costs (inpatient, outpatient, medication costs) and utilization (visits, hospitalizations) were compared between patients with and without IBD, and between IBD patients treated with and without biologics. Results were extrapolated to the Swiss general population using national census data. Multivariate linear regression was used to identify socio-demographic and regional factors influencing total costs.Results: The overall extrapolated prevalence rates of IBD were 0.32% in 2010, 0.38% in 2012, and 0.41% in 2014. Mortality rate didn't differ between the IBD and non-IBD population. Costs increased annually by 6% in IBD versus 2.4% in non-IBD subjects, which was solely due to increased outpatient costs. Almost one-fourth of IBD patients were hospitalized at least once a year. Costs were higher in IBD patients treated with biologics (OR = 3.98, CI: 3.72-4.27, p < 0.001) when compared to IBD patients without biologic therapies. Over 70% of the total costs in IBD patients treated with biologics were due to drug costs, compared with 28% in patients without use of biologic therapies, whereas inpatient costs didn't differ.Conclusions: The prevalence of IBD seems to be increasing in Switzerland. Outpatient costs increased substantially, while no decrease in inpatient costs was found. Treatment of IBD is more and more based on biologic therapies. [ABSTRACT FROM AUTHOR]- Published
- 2017
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10. Multimorbidity, health care utilization and costs in an elderly community-dwelling population: a claims data based observational study.
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Bähler, Caroline, Huber, Carola A., Brüngger, Beat, and Reich, Oliver
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MEDICAL care use ,SOCIODEMOGRAPHIC factors ,HOME care services ,HEALTH surveys ,HEALTH insurance companies ,HEALTH insurance ,MEDICAL care costs ,MEDICAL care - Abstract
Background Chronic conditions and multimorbidity have become one of the main challenges in health care worldwide. However, data on the burden of multimorbidity are still scarce. The purpose of this study is to examine the association between multimorbidity and the health care utilization and costs in the Swiss community-dwelling population, taking into account several sociodemographic factors. Methods The study population consists of 229'493 individuals aged 65 or older who were insured in 2013 by the Helsana Group, the leading health insurer in Switzerland, covering all 26 Swiss cantons. Multimorbidity was defined as the presence of two or more chronic conditions of a list of 22 conditions that were identified using an updated measure of the Pharmacy-based Cost Group model. The number of consultations (total and divided by primary care physicians and specialists), the number of different physicians contacted, the type of physician contact (face-to-face, phone, and home visits), the number of hospitalisations and the length of stay were assessed separately for the multimorbid and non-multimorbid sample. The costs (total and divided by inpatient and outpatient costs) covered by the compulsory health insurance were calculated for both samples. Multiple linear regression modelling was conducted to adjust for influencing factors: age, sex, linguistic region, purchasing power, insurance plan, and nursing dependency.Results Prevalence of multimorbidity was 76.6%. The mean number of consultations per year was 15.7 in the multimorbid compared to 4.4 in the non-multimorbid sample. Total costs were 5.5 times higher in multimorbid patients. Each additional chronic condition was associated with an increase of 3.2 consultations and increased costs of 33%. Strong positive associations with utilization and costs were also found for nursing dependency. Multimorbid patients were 5.6 times more likely to be hospitalised. Furthermore, results revealed a significant age-gender interaction and a socioeconomic gradient. Conclusions Multimorbidity is associated with substantial higher health care utilization and costs in Switzerland. Quantified data on the current burden of multimorbidity are fundamental for the management of patients in health service delivery systems and for health care policy debates about resource allocation. Strategies for a better coordination of multimorbid patients are urgently needed. [ABSTRACT FROM AUTHOR]
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- 2015
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11. Temporal trends and regional disparities in cancer screening utilization: an observational Swiss claims-based study
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Bähler, Caroline, Brüngger, Beat, Ulyte, Agne, Schwenkglenks, Matthias, von Wyl, Viktor, Dressel, Holger, Gruebner, Oliver, Wei, Wenjia, and Blozik, Eva
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3. Good health
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