Scholarlink

Background <p>Indication for visceral surgical procedures should be based on clinical reasoning only and independent of financial incentives. Yet, there is a lack of studies investigating whether insurance type (basic vs. supplementary private) is associated with surgical procedure rates.</p> Methods <p>In this study we assessed whether incidence rates in adults with supplementary private insurance undergoing visceral surgical, non-emergency, in-patient procedures from 2012 to 2020 are higher compared to those with basic insurance only in Switzerland. We assessed incidence rates (IR) for basic only and supplementary private insurance stratified over time and by different age groups, and we fitted negative binomial regression models adjusted by inverse probability weights for specific visceral surgical procedures.</p> <p>We used primary or secondary discharge procedure codes for one of the following procedures: cholecystectomy, fundoplication, sigmoidectomy, rectopexy, haemorrhoidectomy, inguinal, femoral, and umbilical hernia repair.</p> Results <p>Of 1,954,119 surgical admissions (median age 63, 53.3% male, 15.3% non-Swiss nationality), 70.5% had basic insurance only. People with supplementary private insurance had a 7% higher probability (IRR, 1.07, 99% CI 1.06–1.07) to have a visceral surgical procedure done compared to people with basic insurance only—a result consistent across different types of procedures including cholecystectomy (IRR, 1.06, 99% CI 1.06–1.06), fundoplication (IRR, 1.09, 99% CI 1.09–1.10), sigmoidectomy (IRR, 1.10, 99% CI 1.10–1.10), rectopexy (IRR, 1.05, 99% CI 1.04–1.06), haemorrhoidectomy (IRR, 1.04, 99% CI 1.03–1.04), and hernia repair (IRR, 1.07, 99% CI 1.07–1.07). Sensitivity analyses, including side procedures, stratification by length of stay, and propensity score matching, suggested robustness of the results.</p> Conclusion <p>In this cohort study, supplementary private insurance was independently associated with a higher probability of undergoing a visceral surgical procedure. The role of financial incentives in surgical procedures is still unclear.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Association between health care insurance type and rates of visceral surgical procedures in Switzerland. A population-based weighted retrospective cohort study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年7月3日

查看全文
  • Kris Rafaisz,
  • Flurina Suter,
  • Sabine Rohrmann,
  • Beat Mueller,
  • Philipp Schuetz,
  • Christian Andreas Nebiker,
  • Alexander Kutz,
  • Tristan Struja

摘要

Background

Indication for visceral surgical procedures should be based on clinical reasoning only and independent of financial incentives. Yet, there is a lack of studies investigating whether insurance type (basic vs. supplementary private) is associated with surgical procedure rates.

Methods

In this study we assessed whether incidence rates in adults with supplementary private insurance undergoing visceral surgical, non-emergency, in-patient procedures from 2012 to 2020 are higher compared to those with basic insurance only in Switzerland. We assessed incidence rates (IR) for basic only and supplementary private insurance stratified over time and by different age groups, and we fitted negative binomial regression models adjusted by inverse probability weights for specific visceral surgical procedures.

We used primary or secondary discharge procedure codes for one of the following procedures: cholecystectomy, fundoplication, sigmoidectomy, rectopexy, haemorrhoidectomy, inguinal, femoral, and umbilical hernia repair.

Results

Of 1,954,119 surgical admissions (median age 63, 53.3% male, 15.3% non-Swiss nationality), 70.5% had basic insurance only. People with supplementary private insurance had a 7% higher probability (IRR, 1.07, 99% CI 1.06–1.07) to have a visceral surgical procedure done compared to people with basic insurance only—a result consistent across different types of procedures including cholecystectomy (IRR, 1.06, 99% CI 1.06–1.06), fundoplication (IRR, 1.09, 99% CI 1.09–1.10), sigmoidectomy (IRR, 1.10, 99% CI 1.10–1.10), rectopexy (IRR, 1.05, 99% CI 1.04–1.06), haemorrhoidectomy (IRR, 1.04, 99% CI 1.03–1.04), and hernia repair (IRR, 1.07, 99% CI 1.07–1.07). Sensitivity analyses, including side procedures, stratification by length of stay, and propensity score matching, suggested robustness of the results.

Conclusion

In this cohort study, supplementary private insurance was independently associated with a higher probability of undergoing a visceral surgical procedure. The role of financial incentives in surgical procedures is still unclear.