Factors associated with the choice of supplementary hospital insurance in Switzerland – an analysis of the Swiss Health Survey

Abstract Background Switzerland has universal coverage via mandatory health insurance that covers a generous basket of health services. In addition to the basic coverage, the insured can buy supplementary insurance for the inpatient sector. Supplementary hospital insurance in Switzerland provides ad...

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Main Authors: Szilvia Altwicker-Hámori, Michael Stucki
Format: Article
Language:English
Published: BMC 2023-03-01
Series:BMC Health Services Research
Subjects:
Online Access:https://doi.org/10.1186/s12913-023-09221-0
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author Szilvia Altwicker-Hámori
Michael Stucki
author_facet Szilvia Altwicker-Hámori
Michael Stucki
author_sort Szilvia Altwicker-Hámori
collection DOAJ
description Abstract Background Switzerland has universal coverage via mandatory health insurance that covers a generous basket of health services. In addition to the basic coverage, the insured can buy supplementary insurance for the inpatient sector. Supplementary hospital insurance in Switzerland provides additional services during inpatient stays. Little is known about which factors are associated with the choice of semi-private and private hospital insurances. However, this is of importance to policy makers and the insured population, who might be concerned about a “two-class” inpatient care system. Therefore, the aim of the paper was to explore the factors associated with supplementary hospital insurance enrolment in Switzerland. Methods We used the five most recent waves of the representative Swiss Health Survey (1997, 2002, 2007, 2012, 2017) to explore which factors are associated with supplementary hospital insurance enrolment in adults aged 25 or older. We estimated the same probit model for all five surveys waves and computed average marginal effects. Results Our study shows that in all cross-sections the likelihood of enrolling in supplementary hospital insurance increased with higher age, education, household income and was higher for people with a strong preference for unrestricted choice of a specialist and with a higher-than-default deductible choice. The likelihood of supplementary hospital insurance enrolment was lower for the unemployed relative to their inactive counterparts and those living in rural areas relative to comparable urban residents. Ever-smoker status was not statistically significantly associated with supplementary hospital insurance choice. However, our findings indicated differences in estimates over the years regarding demographic as well as insurance-related variables. For example, women were more likely to choose supplementary hospital insurance than comparable men in earlier years. Conclusion Most importantly, our results indicate that factors related to socioeconomic status – such as education, labour market status, and income – consistently show significant associations with the probability of having supplementary hospital insurance for the entire study period, as opposed to demographic variables – such as nationality and sex.
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spelling doaj.art-7f72aa21aa4f4d30ab04337b9e1b685d2023-03-22T10:47:37ZengBMCBMC Health Services Research1472-69632023-03-0123111010.1186/s12913-023-09221-0Factors associated with the choice of supplementary hospital insurance in Switzerland – an analysis of the Swiss Health SurveySzilvia Altwicker-Hámori0Michael Stucki1Institute of Public Health, School of Health Sciences, ZHAW Zurich University of Applied SciencesWinterthur Institute of Health Economics, School of Management and Law, ZHAW Zurich University of Applied SciencesAbstract Background Switzerland has universal coverage via mandatory health insurance that covers a generous basket of health services. In addition to the basic coverage, the insured can buy supplementary insurance for the inpatient sector. Supplementary hospital insurance in Switzerland provides additional services during inpatient stays. Little is known about which factors are associated with the choice of semi-private and private hospital insurances. However, this is of importance to policy makers and the insured population, who might be concerned about a “two-class” inpatient care system. Therefore, the aim of the paper was to explore the factors associated with supplementary hospital insurance enrolment in Switzerland. Methods We used the five most recent waves of the representative Swiss Health Survey (1997, 2002, 2007, 2012, 2017) to explore which factors are associated with supplementary hospital insurance enrolment in adults aged 25 or older. We estimated the same probit model for all five surveys waves and computed average marginal effects. Results Our study shows that in all cross-sections the likelihood of enrolling in supplementary hospital insurance increased with higher age, education, household income and was higher for people with a strong preference for unrestricted choice of a specialist and with a higher-than-default deductible choice. The likelihood of supplementary hospital insurance enrolment was lower for the unemployed relative to their inactive counterparts and those living in rural areas relative to comparable urban residents. Ever-smoker status was not statistically significantly associated with supplementary hospital insurance choice. However, our findings indicated differences in estimates over the years regarding demographic as well as insurance-related variables. For example, women were more likely to choose supplementary hospital insurance than comparable men in earlier years. Conclusion Most importantly, our results indicate that factors related to socioeconomic status – such as education, labour market status, and income – consistently show significant associations with the probability of having supplementary hospital insurance for the entire study period, as opposed to demographic variables – such as nationality and sex.https://doi.org/10.1186/s12913-023-09221-0Supplementary hospital insuranceInpatient careSwitzerlandProbitSwiss Health Survey
spellingShingle Szilvia Altwicker-Hámori
Michael Stucki
Factors associated with the choice of supplementary hospital insurance in Switzerland – an analysis of the Swiss Health Survey
BMC Health Services Research
Supplementary hospital insurance
Inpatient care
Switzerland
Probit
Swiss Health Survey
title Factors associated with the choice of supplementary hospital insurance in Switzerland – an analysis of the Swiss Health Survey
title_full Factors associated with the choice of supplementary hospital insurance in Switzerland – an analysis of the Swiss Health Survey
title_fullStr Factors associated with the choice of supplementary hospital insurance in Switzerland – an analysis of the Swiss Health Survey
title_full_unstemmed Factors associated with the choice of supplementary hospital insurance in Switzerland – an analysis of the Swiss Health Survey
title_short Factors associated with the choice of supplementary hospital insurance in Switzerland – an analysis of the Swiss Health Survey
title_sort factors associated with the choice of supplementary hospital insurance in switzerland an analysis of the swiss health survey
topic Supplementary hospital insurance
Inpatient care
Switzerland
Probit
Swiss Health Survey
url https://doi.org/10.1186/s12913-023-09221-0
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