What explains the inequalities in healthcare use between immigrants and natives in Switzerland?

Tzogiou, Christina; Boes, Stefan; Brunner, Beatrice

Publication type:	Conference other
Type of review:	No review
Title:	What explains the inequalities in healthcare use between immigrants and natives in Switzerland?
Authors:	Tzogiou, Christina Boes, Stefan Brunner, Beatrice
et. al:	No
Conference details:	iHEA 2019 World Congress on Health Economics, Basel, Switzerland, 13-17 July 2019
Issue Date:	15-Jul-2019
Language:	English
Subject (DDC):	362: Health and social services
Abstract:	Background: Even in a high income country, such as Switzerland, immigrants tend to suffer higher rates of mortality and morbidity compared to natives. Foreign nationals are an indispensable component of the Swiss demography and labor force. They comprise 25% of the permanent population, with the majority coming from EU/EFTA states. At the same time, the immigrant population in Switzerland is very heterogeneous. Unequal access to prevention, care and support can have considerable health and cost implications for the whole society. A better understanding of the inequalities in healthcare use is key for the design of cost-effective interventions towards the improvement of national health and a sustainable solidarity-based healthcare system. Objective: The aim of this study is to explain the inequalities in healthcare use between different immigrant groups and natives in Switzerland. The inequality measures examined are the probability of visiting a doctor or an emergency department, as well as the number of doctor and emergency department visits in the past 12 months. Data and methods: The data are drawn from the Swiss Health Survey 2012 and the Health Monitoring Survey on the immigrant population 2010 in Switzerland. The data contain information on the health status, healthcare utilization, and socioeconomic characteristics. We differentiate immigrants between first- and second generation and culturally similar and different to natives. To retrieve the relative contribution of each inequality factor we apply a non-linear decomposition method based on the Oaxaca-Blinder approach. We further extend the model by categorizing the factors into different groups, such as circumstances and effort. Results: Swiss are more likely to visit the doctor compared to overall, to first generation and to culturally different immigrants. These differences could be reduced by 87%, 63% and 40%, respectively, if the corresponding immigrant groups had the same endowments as the Swiss. The contribution of effort accounts for most of the explained inequalities. Swiss also go more often to the doctor compared to the aforementioned immigrant groups. While these differences could be decreased significantly if overall and first generation immigrants had the same endowments as Swiss, the inequality between Swiss and culturally different is mainly attributed to the differences in their coefficients. Culturally similar immigrants are more likely to visit the emergency department and also exhibit a higher number of visits. Since they are fairly similar in their characteristics to the Swiss, these inequalities are mainly attributed to the differences in the coefficients. On the other hand, culturally different immigrants are less likely to visit the emergency department. The main contributing factor is the amount of the annual health insurance deductible chosen. Conclusions: Healthcare utilization is lower in the immigrants most divergent from the Swiss and higher in the culturally similar. The contributions of these inequalities are heterogeneous across the four inequality measures and comparison groups. It is, therefore, important to develop customized strategies to reduce differences in endowments, but also further investigate the drivers of the differences in the coefficients.
URI:	https://digitalcollection.zhaw.ch/handle/11475/19974
Fulltext version:	Published version
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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Tzogiou, C., Boes, S., & Brunner, B. (2019, July 15). What explains the inequalities in healthcare use between immigrants and natives in Switzerland? iHEA 2019 World Congress on Health Economics, Basel, Switzerland, 13-17 July 2019.

Tzogiou, C., Boes, S. and Brunner, B. (2019) ‘What explains the inequalities in healthcare use between immigrants and natives in Switzerland?’, in iHEA 2019 World Congress on Health Economics, Basel, Switzerland, 13-17 July 2019.

C. Tzogiou, S. Boes, and B. Brunner, “What explains the inequalities in healthcare use between immigrants and natives in Switzerland?,” in iHEA 2019 World Congress on Health Economics, Basel, Switzerland, 13-17 July 2019, Jul. 2019.

TZOGIOU, Christina, Stefan BOES und Beatrice BRUNNER, 2019. What explains the inequalities in healthcare use between immigrants and natives in Switzerland? In: iHEA 2019 World Congress on Health Economics, Basel, Switzerland, 13-17 July 2019. Conference presentation. 15 Juli 2019

Tzogiou, Christina, Stefan Boes, and Beatrice Brunner. 2019. “What Explains the Inequalities in Healthcare Use between Immigrants and Natives in Switzerland?” Conference presentation. In iHEA 2019 World Congress on Health Economics, Basel, Switzerland, 13-17 July 2019.

Tzogiou, Christina, et al. “What Explains the Inequalities in Healthcare Use between Immigrants and Natives in Switzerland?” iHEA 2019 World Congress on Health Economics, Basel, Switzerland, 13-17 July 2019, 2019.