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The European Journal of Health Economics

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Open Access 01-11-2018 | Original Paper

How much does the treatment of each major disease cost? A decomposition of Swiss National Health Accounts

Authors: Simon Wieser, Marco Riguzzi, Mark Pletscher, Carola A. Huber, Harry Telser, Matthias Schwenkglenks

Published in: The European Journal of Health Economics | Issue 8/2018

Abstract

In most countries, surprisingly little is known on how national healthcare spending is distributed across diseases. Single-disease cost-of-illness studies cover only a few of the diseases affecting a population and in some cases lead to untenably large estimates. The objective of this study was to decompose healthcare spending in 2011, according to Swiss National Health Accounts, into 21 collectively exhaustive and mutually exclusive major disease categories. Diseases were classified following the Global Burden of Disease Study. We first assigned the expenditures directly mapping from National Health Accounts to the 21 diseases. The remaining expenditures were assigned based on diagnostic codes and clues contained in a variety of microdata sources. Expenditures were dominated by non-communicable diseases with a share of 79.4%. Cardiovascular diseases stood out with 15.6% of total spending, followed by musculoskeletal disorders (13.4%), and mental and substance use disorders (10.6%). Neoplasms (6.0% of the total) ranked only sixth, although they are the leading cause of premature death in Switzerland. These results may be useful for the design of health policies, as they illustrate how healthcare spending is influenced by the epidemiological transition and increasing life expectancy. They also provide a plausibility check for single cost-of-illness studies. Our study may serve as a starting point for further research on the drivers of the constant growth of healthcare spending.

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Per capita spending was 9666 Swiss francs (CHF) in 2016 [20] with an exchange rate of 0.985 CHF/USD [21]. The share of healthcare spending in GDP was lower in Switzerland than in the US (12.4 vs. 17.2%) [20] due to higher per capita income in Switzerland.

Swiss NHA decompose health expenditures from four perspectives: (1) financing source, (2) financing regimen, (3) type of service provider, (4) type of service. In April 2017, the Swiss Federal Office of Statistics published a new version of NHA with a revised classification within these perspectives [13]. Our study is based on the previously published version.

AP-DRG was a prospective payment system (PPS) for acute care hospital stays used in the western and central cantons of Switzerland until 2011. In 2012, the new national SwissDRG PPS replaced it [9].

Private supplementary health insurance covers higher than standard hotel services and treatment by a head physician.

Average exchange rates in 2011 were 0.811 EUR/CHF and 1.127 USD/CHF [21].

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Title: How much does the treatment of each major disease cost? A decomposition of Swiss National Health Accounts
Authors: Simon Wieser
Marco Riguzzi
Mark Pletscher
Carola A. Huber
Harry Telser
Matthias Schwenkglenks
Publication date: 01-11-2018
Publisher: Springer Berlin Heidelberg
Published in: The European Journal of Health Economics / Issue 8/2018
Print ISSN: 1618-7598
Electronic ISSN: 1618-7601
DOI: https://doi.org/10.1007/s10198-018-0963-5

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How much does the treatment of each major disease cost? A decomposition of Swiss National Health Accounts

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