Does the shift in initial care provision from general practitioners to emergency departments lead to an increase in costs? :  a decomposition analysis with accident claims data

Thommen, Christoph; Stucki, Michael; Scholz-Odermatt, Stefan; Höglinger, Marc

doi:10.2139/ssrn.4635352

Publication type:	Working paper – expertise – study
Title:	Does the shift in initial care provision from general practitioners to emergency departments lead to an increase in costs? : a decomposition analysis with accident claims data
Authors:	Thommen, Christoph Stucki, Michael Scholz-Odermatt, Stefan Höglinger, Marc
et. al:	No
DOI:	10.2139/ssrn.4635352
Extent:	23
Issue Date:	28-Nov-2023
Publisher / Ed. Institution:	SSRN
Language:	English
Subjects:	Distribution regression; Emergency department; Primary care; General practitioner; Health care costs; Decomposition; Claims data; Gesundheitsökonomie
Subject (DDC):	362.1041: Health economics
Abstract:	General practitioners (GPs) are expected to provide efficient and effective care and serve as coordinators of subsequent treatment pathways. The recent shift of initial care provision from GPs to emergency departments (EDs) therefore raises concerns of driving up costs. We use claims data from the largest Swiss accident insurer (more than 300,000 cases per year) and decompose the change in long-term health care costs per case between 2008 and 2018 into explaining factors across the full distribution. Contrary to our expectation, we find that the type of initial provider (GPs, specialists or EDs) makes no relevant contribution to changes in costs. What really drives cost growth is the increase in the number of different types of supporting providers involved, such as radiologists or physiotherapists, in particular among patients initially treated by a GP.
URI:	https://digitalcollection.zhaw.ch/handle/11475/30618
License (according to publishing contract):	Licence according to publishing contract
Departement:	School of Management and Law
Organisational Unit:	Winterthur Institute of Health Economics (WIG)
Appears in collections:	Publikationen School of Management and Law

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Thommen, C., Stucki, M., Scholz-Odermatt, S., & Höglinger, M. (2023). Does the shift in initial care provision from general practitioners to emergency departments lead to an increase in costs? : a decomposition analysis with accident claims data. SSRN. https://doi.org/10.2139/ssrn.4635352

Thommen, C. et al. (2023) Does the shift in initial care provision from general practitioners to emergency departments lead to an increase in costs? : a decomposition analysis with accident claims data. SSRN. Available at: https://doi.org/10.2139/ssrn.4635352.

C. Thommen, M. Stucki, S. Scholz-Odermatt, and M. Höglinger, “Does the shift in initial care provision from general practitioners to emergency departments lead to an increase in costs? : a decomposition analysis with accident claims data,” SSRN, Nov. 2023. doi: 10.2139/ssrn.4635352.

THOMMEN, Christoph, Michael STUCKI, Stefan SCHOLZ-ODERMATT und Marc HÖGLINGER, 2023. Does the shift in initial care provision from general practitioners to emergency departments lead to an increase in costs? : a decomposition analysis with accident claims data. SSRN

Thommen, Christoph, Michael Stucki, Stefan Scholz-Odermatt, and Marc Höglinger. 2023. “Does the Shift in Initial Care Provision from General Practitioners to Emergency Departments Lead to an Increase in Costs? : A Decomposition Analysis with Accident Claims Data.” SSRN. https://doi.org/10.2139/ssrn.4635352.

Thommen, Christoph, et al. Does the Shift in Initial Care Provision from General Practitioners to Emergency Departments Lead to an Increase in Costs? : A Decomposition Analysis with Accident Claims Data. SSRN, 28 Nov. 2023, https://doi.org/10.2139/ssrn.4635352.