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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Published in:International journal of public health 2021-10, Vol.66, p.1604073-1604073
Main Authors: Schneider, Rémi, Näpflin, Markus, Syrogiannouli, Lamprini, Bissig, Sarah, Tal, Kali, Bulliard, Jean-Luc, Ducros, Cyril, Senn, Oliver, Selby, Kevin, Bähler, Caroline, Blozik, Eva, Auer, Reto
Format: Article
Language:English
Subjects:
colonoscopy
colorectal cancer screening
fecal occult blood test
Public Health Archive
Swiss health insurance
testing rates
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Summary: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.
ISSN:1661-8564
1661-8556
1661-8564
DOI:10.3389/ijph.2021.1604073