Decomposition of outpatient health care spending by disease - a novel approach using insurance claims data.

ABSTRACT:

Background

Decomposing health care spending by disease, type of care, age, and sex can lead to a better understanding of the drivers of health care spending. But the lack of diagnostic coding in outpatient care often precludes a decomposition by disease. Yet, health insurance claims data hold a variety of diagnostic clues that may be used to identify diseases.

Methods

In this study, we decompose total outpatient care spending in Switzerland by age, sex, service type, and 42 exhaustive and mutually exclusive diseases according to the Global Burden of Disease classification. Using data of a large health insurance provider, we identify diseases based on diagnostic clues. These clues include type of medication, inpatient treatment, physician specialization, and disease specific

SUBMITTER: Stucki M 

PROVIDER: S-EPMC8609863 | biostudies-literature | 2021 Nov

REPOSITORIES: biostudies-literature