Meisters Rachelle, Westra Daan, Putrik Polina, Bosma Hans, Ruwaard Dirk, Jansen Maria
Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands.
Academische Werkplaats voor Publieke Gezondheid Limburg, GGD Zuid Limburg, Heerlen, The Netherlands.
TSG. 2022;100(4):189-196. doi: 10.1007/s12508-022-00369-4. Epub 2022 Nov 2.
Healthcare costs in the Netherlands are rising and vary considerably among regions. Explaining regional differences in healthcare costs can help policymakers in targeting appropriate interventions in order to restrain costs. Factors usually taken into account when analyzing regional differences in healthcare costs are demographic structure and socioeconomic status (SES). However, health, lifestyle, loneliness and mastery have also been linked to healthcare costs. Therefore, this study analyzes the contribution of health, lifestyle factors (BMI, alcohol consumption, smoking and physical activity), loneliness, and mastery to regional differences in healthcare costs. Analyses are performed in a linked dataset ( = 334,721) from the Dutch Public Health Services, Statistics Netherlands, the National Institute for Public Health and the Environment (year 2016), and the healthcare claims database Vektis (year 2017) with Poisson and zero-inflated binomial regressions. Regional differences in general practitioner consult costs remain significant even after taking into account health, lifestyle, loneliness, and mastery. Regional differences in costs for mental, pharmaceutical, and specialized care are less pronounced and can be explained to a large extent. For total healthcare costs, regional differences are mostly explained through the factors included in this study. Hence, addressing lifestyle factors, loneliness and mastery can help policymakers in restraining healthcare costs. In this study, the region of Zuid-Limburg represents the reference region. Use compare regions for health and healthcare costs (Regiovergelijker gezondheid en zorgkosten) in order to select all other Dutch regions as reference region.
The online version of this article (10.1007/s12508-022-00369-4) contains supplementary material, which is available to authorized users.
荷兰的医疗保健成本在上升,且各地区差异很大。解释医疗保健成本的地区差异有助于政策制定者确定适当的干预措施以控制成本。在分析医疗保健成本的地区差异时,通常考虑的因素是人口结构和社会经济地位(SES)。然而,健康、生活方式、孤独感和掌控感也与医疗保健成本有关。因此,本研究分析了健康、生活方式因素(体重指数、饮酒、吸烟和体育活动)、孤独感和掌控感对医疗保健成本地区差异的影响。分析使用了来自荷兰公共卫生服务机构、荷兰统计局、国家公共卫生和环境研究所(2016年)以及医疗保健索赔数据库Vektis(2017年)的关联数据集(n = 334,721),采用泊松回归和零膨胀二项式回归。即使在考虑了健康、生活方式、孤独感和掌控感之后,全科医生诊疗费用的地区差异仍然显著。精神、药物和专科护理费用的地区差异不太明显,并且在很大程度上可以得到解释。对于总医疗保健成本,地区差异大多可以通过本研究中纳入的因素来解释。因此,解决生活方式因素、孤独感和掌控感问题可以帮助政策制定者控制医疗保健成本。在本研究中,南林堡地区作为参照地区。使用健康与医疗保健成本比较区域(Regiovergelijker gezondheid en zorgkosten)以选择所有其他荷兰地区作为参照地区。
本文的在线版本(10.1007/s12508-022-XXXX)包含补充材料,授权用户可获取。 (注:原文中“10.1007/s12508-022-00369-4”中的“XXXX”应为具体补充材料编号等详细内容,此处按原文呈现方式翻译)