Change in Colorectal Cancer Tests Submitted for Reimbursement in Switzerland 2012–2018: Evidence from Claims Data of a Large Insurance

Objectives: Guidelines recommend colorectal cancer (CRC) screening by fecal occult blood test (FOBT) or colonoscopy. In 2013, Switzerland introduced reimbursement of CRC screening by mandatory health insurance for 50-69-years-olds, after they met their deductible. We hypothesized that the 2013 reimb...

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Autores principales:	Rémi Schneider, Markus Näpflin, Lamprini Syrogiannouli, Sarah Bissig, Kali Tal, Jean-Luc Bulliard, Cyril Ducros, Oliver Senn, Kevin Selby, Caroline Bähler, Eva Blozik, Reto Auer
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	colorectal cancer screening fecal occult blood test colonoscopy testing rates Swiss health insurance Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/5902c84a04d44948a4b6ea3d015bf56a
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spelling	oai:doaj.org-article:5902c84a04d44948a4b6ea3d015bf56a2021-11-09T15:17:05ZChange in Colorectal Cancer Tests Submitted for Reimbursement in Switzerland 2012–2018: Evidence from Claims Data of a Large Insurance1661-856410.3389/ijph.2021.1604073https://doaj.org/article/5902c84a04d44948a4b6ea3d015bf56a2021-10-01T00:00:00Zhttps://www.ssph-journal.org/articles/10.3389/ijph.2021.1604073/fullhttps://doaj.org/toc/1661-8564Objectives: Guidelines recommend colorectal cancer (CRC) screening by fecal occult blood test (FOBT) or colonoscopy. In 2013, Switzerland introduced reimbursement of CRC screening by mandatory health insurance for 50-69-years-olds, after they met their deductible. We hypothesized that the 2013 reimbursement policy increased testing rate.Methods: In claims data from a Swiss insurance, we determined yearly CRC testing rate among 50-75-year-olds (2012–2018) and the association with socio-demographic, insurance-, and health-related covariates with multivariate-adjusted logistic regression models. We tested for interaction of age (50–69/70–75) on testing rate over time.Results: Among insurees (2012:355′683; 2018:348′526), yearly CRC testing rate increased from 2012 to 2018 (overall: 8.1–9.9%; colonoscopy: 5.0–7.6%; FOBT: 3.1–2.3%). Odds ratio (OR) were higher for 70–75-year-olds (2012: 1.16, 95%CI 1.13–1.20; 2018: 1.05, 95%CI 1.02–1.08). Deductible interacted with changes in testing rate over time (p < 0.001). The increase in testing rate was proportionally higher among 50-69-years-olds than 70-75-year-olds over the years.Conclusions: CRC testing rate in Switzerland increased from 2012 to 2018, particularly among 50-69-years-olds, the target population of the 2013 law. Future studies should explore the effect of encouraging FOBT or waiving deductible.Rémi SchneiderMarkus NäpflinLamprini SyrogiannouliSarah BissigKali TalJean-Luc BulliardCyril DucrosOliver SennKevin SelbyCaroline BählerEva BlozikReto AuerFrontiers Media S.A.articlecolorectal cancer screeningfecal occult blood testcolonoscopytesting ratesSwiss health insurancePublic aspects of medicineRA1-1270ENInternational Journal of Public Health, Vol 66 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	colorectal cancer screening fecal occult blood test colonoscopy testing rates Swiss health insurance Public aspects of medicine RA1-1270
spellingShingle	colorectal cancer screening fecal occult blood test colonoscopy testing rates Swiss health insurance Public aspects of medicine RA1-1270 Rémi Schneider Markus Näpflin Lamprini Syrogiannouli Sarah Bissig Kali Tal Jean-Luc Bulliard Cyril Ducros Oliver Senn Kevin Selby Caroline Bähler Eva Blozik Reto Auer Change in Colorectal Cancer Tests Submitted for Reimbursement in Switzerland 2012–2018: Evidence from Claims Data of a Large Insurance
description	Objectives: Guidelines recommend colorectal cancer (CRC) screening by fecal occult blood test (FOBT) or colonoscopy. In 2013, Switzerland introduced reimbursement of CRC screening by mandatory health insurance for 50-69-years-olds, after they met their deductible. We hypothesized that the 2013 reimbursement policy increased testing rate.Methods: In claims data from a Swiss insurance, we determined yearly CRC testing rate among 50-75-year-olds (2012–2018) and the association with socio-demographic, insurance-, and health-related covariates with multivariate-adjusted logistic regression models. We tested for interaction of age (50–69/70–75) on testing rate over time.Results: Among insurees (2012:355′683; 2018:348′526), yearly CRC testing rate increased from 2012 to 2018 (overall: 8.1–9.9%; colonoscopy: 5.0–7.6%; FOBT: 3.1–2.3%). Odds ratio (OR) were higher for 70–75-year-olds (2012: 1.16, 95%CI 1.13–1.20; 2018: 1.05, 95%CI 1.02–1.08). Deductible interacted with changes in testing rate over time (p < 0.001). The increase in testing rate was proportionally higher among 50-69-years-olds than 70-75-year-olds over the years.Conclusions: CRC testing rate in Switzerland increased from 2012 to 2018, particularly among 50-69-years-olds, the target population of the 2013 law. Future studies should explore the effect of encouraging FOBT or waiving deductible.
format	article
author	Rémi Schneider Markus Näpflin Lamprini Syrogiannouli Sarah Bissig Kali Tal Jean-Luc Bulliard Cyril Ducros Oliver Senn Kevin Selby Caroline Bähler Eva Blozik Reto Auer
author_facet	Rémi Schneider Markus Näpflin Lamprini Syrogiannouli Sarah Bissig Kali Tal Jean-Luc Bulliard Cyril Ducros Oliver Senn Kevin Selby Caroline Bähler Eva Blozik Reto Auer
author_sort	Rémi Schneider
title	Change in Colorectal Cancer Tests Submitted for Reimbursement in Switzerland 2012–2018: Evidence from Claims Data of a Large Insurance
title_short	Change in Colorectal Cancer Tests Submitted for Reimbursement in Switzerland 2012–2018: Evidence from Claims Data of a Large Insurance
title_full	Change in Colorectal Cancer Tests Submitted for Reimbursement in Switzerland 2012–2018: Evidence from Claims Data of a Large Insurance
title_fullStr	Change in Colorectal Cancer Tests Submitted for Reimbursement in Switzerland 2012–2018: Evidence from Claims Data of a Large Insurance
title_full_unstemmed	Change in Colorectal Cancer Tests Submitted for Reimbursement in Switzerland 2012–2018: Evidence from Claims Data of a Large Insurance
title_sort	change in colorectal cancer tests submitted for reimbursement in switzerland 2012–2018: evidence from claims data of a large insurance
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/5902c84a04d44948a4b6ea3d015bf56a
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Change in Colorectal Cancer Tests Submitted for Reimbursement in Switzerland 2012–2018: Evidence from Claims Data of a Large Insurance

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