International Journal of Public Health (Oct 2021)

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

  • 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

DOI
https://doi.org/10.3389/ijph.2021.1604073
Journal volume & issue
Vol. 66

Abstract

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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.

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