High prevalence of not seeking healthcare for economic reasons in Switzerland: a population-based study in a region with universal health insurance coverage

I. Guessous, J-M. Gaspoz, J-M. Theler, H. Wolff.
High prevalence of forgoing healthcare for economic reasons in Switzerland: A population-based study in a region with universal health insurance coverage.Preventive Medicine, 23 August 2012, doi: 10.1016/j.ypmed.2012.08.005

Abstract

Objective: To examine the determinants of and 4-year trends in the avoidance of health care for economic reasons in Switzerland.

Methods: Population-based survey (2007-2010) of a representative sample aged 35 to 74 in the canton of Geneva, Switzerland. Renunciation of care, socio-economic and health insurance status, marital status and presence of dependent children were assessed using standardised methods.

Results: A total of 2,601 people were included in the analyses. 13.8% of participants (358/2601) said they had given up healthcare for economic reasons, the percentage varying from 3.7% in the group with a monthly income ≥ 13,000 CHF (1 CHF ≈ 1 $) to 30.9% in the group with a monthly income < 3,000 CHF. Among participants with a monthly income < 3,000 CHF, the percentage of people who gave up healthcare for economic reasons rose from 22.5% in 2007/8 to 34.7% in 2010 (trend P = 0.2). Giving up healthcare for economic reasons was associated with low income, being female, active smoking, having a lower professional position, having dependent children, being divorced and single, paying a higher health insurance excess, and receiving a health insurance premium subsidy.

Conclusions: In a Swiss region with universal health insurance coverage, the self-reported prevalence of foregoing healthcare for economic reasons was high and strongly dependent on socio-economic factors. Our data suggest an upward trend among participants with the lowest incomes.

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