How much does the treatment of each major disease cost? A decomposition of Swiss National Health Accounts

Simon Wieser,Carola A Huber,Matthias Schwenkglenks,Harry Telser,Marco Riguzzi,Mark Pletscher

doi:10.1007/s10198-018-0963-5

Abstract

In most countries, surprisingly little is known on how national healthcare spending is distributed across diseases. Single-disease cost-of-illness studies cover only a few of the diseases affecting a population and in some cases lead to untenably large estimates. The objective of this study was to decompose healthcare spending in 2011, according to Swiss National Health Accounts, into 21 collectively exhaustive and mutually exclusive major disease categories. Diseases were classified following the Global Burden of Disease Study. We first assigned the expenditures directly mapping from National Health Accounts to the 21 diseases. The remaining expenditures were assigned based on diagnostic codes and clues contained in a variety of microdata sources. Expenditures were dominated by non-communicable diseases with a share of 79.4%. Cardiovascular diseases stood out with 15.6% of total spending, followed by musculoskeletal disorders (13.4%), and mental and substance use disorders (10.6%). Neoplasms (6.0% of the total) ranked only sixth, although they are the leading cause of premature death in Switzerland. These results may be useful for the design of health policies, as they illustrate how healthcare spending is influenced by the epidemiological transition and increasing life expectancy. They also provide a plausibility check for single cost-of-illness studies. Our study may serve as a starting point for further research on the drivers of the constant growth of healthcare spending.

Highlights

It is quite well known how healthcare spending is financed and what kind of services are bought, surprisingly little is known on how much is spent on each major disease.University of Zurich, Zurich, Switzerland1 3 Vol.:(0123456789)Policy interventions that aim at improving population health require a thorough understanding of the importance of single diseases and the evolution of disease-specific expenditures over time
We added a fifth dimension to Swiss National Health Accounts (NHA) in addition to the four dimensions already provided by the Federal Office of Statistics (FOS) [4]
The results showed that non-communicable diseases dominated healthcare spending in 2011 accounting for 79.4% of total spending

Summary

Introduction

It is quite well known how healthcare spending is financed and what kind of services are bought, surprisingly little is known on how much is spent on each major disease.University of Zurich, Zurich, Switzerland1 3 Vol.:(0123456789)Policy interventions that aim at improving population health require a thorough understanding of the importance of single diseases and the evolution of disease-specific expenditures over time. A growing number of cost-of-illness studies have assessed the costs of single diseases in a variety of countries [1]. These studies usually cover only a fraction of the diseases affecting a country’s population, and they are often criticized for overestimating the true costs of diseases [2, 3]. This overestimation may be due to methodological difficulties in isolating the expenditures for a specific disease in patients affected by multiple conditions. It may be the consequence of an overestimation bias when researchers highlight the economic impact of the disease under study

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Conclusion