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Amendola S, Hengartner MP. Antidepressants use in Italy: an ecological study of national and regional trends and associated factors. Int Clin Psychopharmacol 2024; 39:93-105. [PMID: 37966155 DOI: 10.1097/yic.0000000000000522] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
The present study aimed to (1) provide an update on trends in AD consumption both at the national and regional unit of analysis for the period 2000-2020 in Italy and (2) analyze sociodemographic and healthcare system-related factors associated with AD prescribing at the regional-population level between 2000 and 2019. Data were extracted from reports of the Italian Medicines Agency and databases of the Italian National Institute of Statistics. Linear regression and mixed models were applied to analyze trends in AD use (DDD/1000/day) and ecological factors associated with AD prescribing. Between 2000 and 2010 AD prescription rates constantly increased. Thereafter they stabilized until 2017 when a positive trend began again. There was a positive ecological association between AD prescribing and rates of hospital discharge due to affective disorders, antibiotics prescribing, public non-drug healthcare spending per capita, and Northern regions compared to Southern regions. AD consumption increased massively during the 2000s, flattened during the 2010s but thereafter increased again until 2020. The ecological correlation between healthcare provision/spending and AD consumption suggests that health-economic factors may play an important role.
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Affiliation(s)
- Simone Amendola
- Department of Applied Psychology, Zurich University of Applied Sciences, Zurich, Switzerland
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Hjalmarsson L, Kaiser B, Bischof T. The impact of physician exits in primary care: A study of practice handovers. Health Policy 2023; 135:104867. [PMID: 37437479 DOI: 10.1016/j.healthpol.2023.104867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 06/15/2023] [Accepted: 06/30/2023] [Indexed: 07/14/2023]
Abstract
Recent studies on physician exits suggest that general practitioners (GPs) have an important impact on health care utilization and costs, but the transmission channels - interpersonal dis- continuities of care, practice style differences and deterioration in access - are usually not clear. Our objective is to estimate the short-run and long-run impacts of switches in GPs on patients' health care utilization and costs, while all other factors of the health care setting remain the same. To do this, we collect data on handovers of primary care practices in Switzerland, occurring between 2007 and 2015. We link this data to rich insurance claims to construct a panel dataset of roughly 240,000 patients. Employing a difference-in-difference type framework, we find transitory increases in overall visits and costs, which are likely caused by the entering GP's initial re-assessment of patients' health care needs. Additionally, we find long-term increases in specialist health care utilization and ambulatory costs. The latter finding can be explained by changes in practice styles between the exiting GP and her successor, who is typically much younger and more likely to be female. In contrast to the literature on practice closures, we do not find evidence on reduced overall utilization rates. An important lesson for health policy is thus to preserve patients' access to care in the case of GP exits.
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Affiliation(s)
- Linn Hjalmarsson
- Department of Economics, University of Bern, Schanzeneckstrasse 1, 3001, Bern, Switzerland.
| | - Boris Kaiser
- BSS Volkswirtschaftliche Beratung, Aeschengraben 9, 4051 Basel, Switzerland
| | - Tamara Bischof
- Interface Politikstudien Forschung Beratung AG, Seidenhofstrasse 12, 6003, Lucerne, Switzerland
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Rachamin Y, Jäger L, Schweighoffer R, Signorell A, Bähler C, Huber CA, Blozik E, Seifritz E, Grischott T, Senn O. The Impact of COVID-19 on Mental Healthcare Utilization in Switzerland Was Strongest Among Young Females-Retrospective Study in 2018-2020. Int J Public Health 2023; 68:1605839. [PMID: 37273771 PMCID: PMC10235482 DOI: 10.3389/ijph.2023.1605839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 05/03/2023] [Indexed: 06/06/2023] Open
Abstract
Objectives: To provide a thorough assessment of the impact of the COVID-19 pandemic on the utilization of inpatient and outpatient mental healthcare in Switzerland. Methods: Retrospective cohort study using nationwide hospital data (n > 8 million) and claims data from a large Swiss health insurer (n > 1 million) in 2018-2020. Incidence proportions of different types of psychiatric inpatient admissions, psychiatric consultations, and psychotropic medication claims were analyzed using interrupted time series models for the general population and for the vulnerable subgroup of young people. Results: Inpatient psychiatric admissions in the general population decreased by 16.2% (95% confidence interval: -19.2% to -13.2%) during the first and by 3.9% (-6.7% to -0.2%) during the second pandemic shutdown, whereas outpatient mental healthcare utilization was not substantially affected. We observed distinct patterns for young people, most strikingly, an increase in mental healthcare utilization among females aged <20 years. Conclusion: Mental healthcare provision for the majority of the population was largely maintained, but special attention should be paid to young people. Our findings highlight the importance of monitoring mental healthcare utilization among different populations.
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Affiliation(s)
- Yael Rachamin
- Institute of Primary Care, University of Zurich and University Hospital Zurich, Zurich, Switzerland
- Campus Stiftung Lindenhof Bern (SLB), Bern, Switzerland
| | - Levy Jäger
- Institute of Primary Care, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Reka Schweighoffer
- Institute for Clinical Research, Department of Medicine, University of Basel, Basel, Switzerland
| | - Andri Signorell
- Department of Health Sciences, Helsana Group, Zurich, Switzerland
| | - Caroline Bähler
- Department of Health Sciences, Helsana Group, Zurich, Switzerland
| | - Carola A. Huber
- Institute of Primary Care, University of Zurich and University Hospital Zurich, Zurich, Switzerland
- Department of Health Sciences, Helsana Group, Zurich, Switzerland
| | - Eva Blozik
- Institute of Primary Care, University of Zurich and University Hospital Zurich, Zurich, Switzerland
- SWICA Health Services Research, Winterthur, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - Thomas Grischott
- Institute of Primary Care, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Oliver Senn
- Institute of Primary Care, University of Zurich and University Hospital Zurich, Zurich, Switzerland
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Hengartner MP, Neuner-Jehle S, Senn O. Correction to: Swiss GPs’ preferences for antidepressant treatment in mild depression: vignette-based quantitative analysis. BMC PRIMARY CARE 2022; 23:27. [PMID: 35135488 PMCID: PMC8827201 DOI: 10.1186/s12875-022-01626-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
An amendment to this paper has been published and can be accessed via the original article.
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