Zweifel P
Soz Praventivmed. 1981 May;26(1-2):81-7. doi: 10.1007/BF02076323.
The working hypothesis is that a cost-insurance spiral is operating in the Swiss health care system. It consists of three causal links. First, insurance coverage is one of the factors influencing the probability with which an individual sees a physician for a given condition. With improved coverage, demand for initial contacts will rise, inducing changes in ambulatory cost per case treated as well as in the propensity of hospitalization. Due to this second relationship, members of the sick funds find themselves exposed to an increased financial risk. Therefore, they tend to adjust coverage accordingly. With this third link, a feedback is established, and the cost-insurance spiral is ready to go into another round. The questions of whether such a spiral exists, the speed with which it turns, and how it could be slowed down are at the core of an investigation that will be completed in 1982. Members of a major sick fund have already been sampled in order to supplement insurance records with socioeconomic data.
目前的工作假设是，瑞士医疗保健系统中存在成本-保险螺旋。它由三个因果联系组成。首先，保险覆盖范围是影响个人因某种特定疾病看医生概率的因素之一。随着覆盖范围的改善，首次就诊的需求将会增加，这会导致每例门诊治疗成本以及住院倾向发生变化。由于这第二个关系，疾病基金的成员发现自己面临更高的财务风险。因此，他们倾向于相应地调整保险范围。通过这第三个联系，形成了一个反馈，成本-保险螺旋准备进入下一轮。这样一个螺旋是否存在、其旋转速度以及如何减缓它等问题，是将于1982年完成的一项调查的核心。为了用社会经济数据补充保险记录，已经对一个主要疾病基金的成员进行了抽样。
