AUTHOR=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
TITLE=Change in Colorectal Cancer Tests Submitted for Reimbursement in Switzerland 2012–2018: Evidence from Claims Data of a Large Insurance
JOURNAL=International Journal of Public Health
VOLUME=66
YEAR=2021
URL=https://www.ssph-journal.org/journals/international-journal-of-public-health/articles/10.3389/ijph.2021.1604073
DOI=10.3389/ijph.2021.1604073
ISSN=1661-8564
ABSTRACT=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.