Does a mandatory telemedicine call prior to visiting a physician reduce costs or simply attract good risks?

This paper aims to estimate empirically the efficiency of a Swiss telemedicine service introduced in 2003. We used claims' data gathered by a major Swiss health insurer, over a period of six years and involving 160 000 insured adults. In Switzerland, health insurance is mandatory, but everyone has the option of choosing between a managed care plan and a fee-for-service plan. The present paper focuses on a conventional fee-for-service plan including a mandatory access to a telemedicine service; the insured are obliged to phone this medical call centre prior to visiting a physician. This type of plan generates much lower average health expenditures than a conventional insurance plan. Reasons for this may include selection, incentive effects or simply efficiency. In our sample, about 90% of the difference in health expenditure can be explained by selection and incentive effects. The remaining 10% of savings due to the efficiency of the telemedicine service amount to about SFr 150 per year per insured, of which approx. 60% is saved by the insurer and 40% by the insured. While the plan is cost-effective, the big winners are the insured who not only save monetary and non-monetary costs, but also benefit from reduced premiums.health, insurance, selection, efficiency, telemedicine

A Score Test for Individual Heteroscedasticity in a One-way Error Components Model

The purpose of this paper is to derive a Rao's efficient score statistic for testing for heteroscedasticity in an error components model with only individual effects. We assume that the individual effect exists and therefore do not test for it. In addition, we assume that the individual effects, and not the white noise term may be heteroscedastic. Finally, we assume that the error components are normally distributed. We first establish, under a specific set of assumptions, the asymptotic distribution of the Score under contiguous alternatives. We then derive the expression for the Score test statistic for individual heteroscedasticity. Finally, we discuss the asymptotic local power of this Score test statistic.panel data; error components model; score test; individual heteroscedasticity: contiguous alternatives; asymptotic local power

Does a mandatory telemedicine call prior to visiting a physician reduce costs or simply attract good risks?

This paper aims to estimate empirically the efficiency of a Swiss telemedicine service introduced in 2003. We used claims' data gathered by a major Swiss health insurer, over a period of six years and involving 160 000 insured adults. In Switzerland, health insurance is mandatory, but everyone has the option of choosing between a managed care plan and a fee-for-service plan. The present paper focuses on a conventional fee-for-service plan including a mandatory access to a telemedicine service; the insured are obliged to phone this medical call centre prior to visiting a physician. This type of plan generates much lower average health expenditures than a conventional insurance plan. Reasons for this may include selection, incentive effects or simply efficiency. In our sample, about 90% of the difference in health expenditure can be explained by selection and incentive effects. The remaining 10% of savings due to the efficiency of the telemedicine service amount to about SFr 150 per year per insured, of which approx. 60% is saved by the insurer and 40% by the insured. While the plan is cost-effective, the big winners are the insured who not only save monetary and non-monetary costs, but also benefit from reduced premiums. [Authors]]]> Telemedicine ; Insurance, Health ; Health Expenditures eng https://serval.unil.ch/resource/serval:BIB_35F8B08AB042.P001/REF.pdf http://nbn-resolving.org/urn/resolver.pl?urn=urn:nbn:ch:serval-BIB_35F8B08AB0429 info:eu-repo/semantics/altIdentifier/urn/urn:nbn:ch:serval-BIB_35F8B08AB0429 info:eu-repo/semantics/submittedVersion info:eu-repo/semantics/openAccess Copying allowed only for non-profit organizations https://serval.unil.ch/disclaimer application/pdf oai:serval.unil.ch:BIB_35F8F0D23516 2022-05-07T01:15:08Z <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_35F8F0D23516 Un renouveau actuel de la rhétorique publicitaire ? Pahud, S. info:eu-repo/semantics/article article 2013 Semen, vol. 36, pp. 21-38 info:eu-repo/semantics/altIdentifier/pissn/9782848674636 fre oai:serval.unil.ch:BIB_35F9AE1514E7 2022-05-07T01:15:08Z <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_35F9AE1514E7 Sick building syndrom Oppliger, Anne info:eu-repo/semantics/article article 2007 Context : le magazine de la SEC Suisse, no. 16, pp. 24 info:eu-repo/semantics/altIdentifier/pissn/1424-5353 Sick Building Syndrome oai:serval.unil.ch:BIB_35FB47E408A5 2022-05-07T01:15:08Z <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_35FB47E408A5 Funding: The Scientific Cooperation Between Eastern Europe and Switzerland Programme Taylor, J. Burnier, M. Abriel, H. info:eu-repo/semantics/article article 2011 Circulation, vol. 124, no. 22, pp. F130-132 info:eu-repo/semantics/altIdentifier/pissn/0009-7322 BLOOD-PRESSURE; SALT eng oai:serval.unil.ch:BIB_35EF3FA2FAD5 2022-05-07T01:15:08Z openaire documents urnserval <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_35EF3FA2FAD5 Risk of herbicide mixtures as a key parameter to explain phytoplankton fluctuation in a great lake: the case of Lake Geneva, Switzerland info:doi:10.1007/s10646-012-0987-z info:eu-repo/semantics/altIdentifier/doi/10.1007/s10646-012-0987-z Gregorio, V. Büchi, L. Anneville, O. Rimet, F. Bouchez, A. Chèvre, N. info:eu-repo/semantics/article article 2012 Ecotoxicology, vol. 21, pp. 2306-2318 urn:issn:1573-3017 eng https://serval.unil.ch/resource/serval:BIB_35EF3FA2FAD5.P001/REF.pdf http://nbn-resolving.org/urn/resolver.pl?urn=urn:nbn:ch:serval-BIB_35EF3FA2FAD58 info:eu-repo/semantics/altIdentifier/urn/urn:nbn:ch:serval-BIB_35EF3FA2FAD58 info:eu-repo/semantics/publishedVersion info:eu-repo/semantics/openAccess Copying allowed only for non-profit organizations https://serval.unil.ch/disclaimer application/pdf oai:serval.unil.ch:BIB_35EF77BD51EC 2022-05-07T01:15:08Z openaire documents urnserval <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_35EF77BD51EC The chemokine CCL2 protects against methylmercury neurotoxicity. info:doi:10.1093/toxsci/kfr252 info:eu-repo/semantics/altIdentifier/doi/10.1093/toxsci/kfr252 info:eu-repo/semantics/altIdentifier/pmid/21976372 Godefroy, D. Gosselin, R.D. Yasutake, A. Fujimura, M. Combadière, C. Maury-Brachet, R. Laclau, M. Rakwal, R. Melik-Parsadaniantz, S. Bourdineaud, J.P. Rostène, W. info:eu-repo/semantics/article article 2012 Toxicological Sciences, vol. 125, no. 1, pp. 209-218 info:eu-repo/semantics/altIdentifier/eissn/1096-0929 urn:issn:1096-0929 <![CDATA[Industrial pollution due to heavy metals such as mercury is a major concern for the environment and public health. Mercury, in particular methylmercury (MeHg), primarily affects brain development and neuronal activity, resulting in neurotoxic effects. Because chemokines can modulate brain functions and are involved in neuroinflammatory and neurodegenerative diseases, we tested the possibility that the neurotoxic effect of MeHg may interfere with the chemokine CCL2. We have used an original protocol in young mice using a MeHg-contaminated fish-based diet for 3 months relevant to human MeHg contamination. We observed that MeHg induced in the mice cortex a decrease in CCL2 concentrations, neuronal cell death, and microglial activation. Knock-out (KO) CCL2 mice fed with a vegetal control food already presented a decrease in cortical neuronal cell density in comparison with wild-type animals under similar diet conditions, suggesting that the presence of CCL2 is required for normal neuronal survival. Moreover, KO CCL2 mice showed a pronounced neuronal cell death in response to MeHg. Using in vitro experiments on pure rat cortical neurons in culture, we observed by blockade of the CCL2/CCR2 neurotransmission an increased neuronal cell death in response to MeHg neurotoxicity. Furthermore, we showed that sod genes are upregulated in brain of wild-type mice fed with MeHg in contrast to KO CCL2 mice and that CCL2 can blunt in vitro the decrease in glutathione levels induced by MeHg. These original findings demonstrate that CCL2 may act as a neuroprotective alarm system in brain deficits due to MeHg intoxication

Separating selection and incentive effects in health insurance

This paper provides an analysis of the health insurance and health care consumption. A structural microeconomic model of joint demand for health insurance and health care is developed and estimated using full maximum likelihood method using Swiss insurance claims data for over 60 000 adult individuals. The estimation strategy relies on the institutional features of the Swiss system, in which each individual chooses among the same menu of contracts, ranked by the size of their deductible. The empirical analysis shows strong and robust evidence of selection effects. Nevertheless, once selection effects are controlled for, an important incentive effect ("ex-post moral hazard") remains. A decrease in the copayment rate from 100% to 10% increases the marginal demand for health care by about 90% and from 100% to 0% by about 150%. The correlation between insurance coverage and health care expenditures may be decomposed into the two effects: 75% may be attributed to selection, and 25 % to incentive effects.health insurance ; demand for health care ; moral hazard ; adverse selection ; full maximum likelihood estimation

Separating selection and incentive effects in health insurance

This paper provides an analysis of the health insurance and health care consumption. A structural microeconomic model of joint demand for health insurance and health care is developed and estimated using full maximum likelihood method using Swiss insurance claims data for over 60 000 adult individuals. The estimation strategy relies on the institutional features of the Swiss system, in which each individual chooses among the same menu of contracts, ranked by the size of their deductible. The empirical analysis shows strong and robust evidence of selection effects. Nevertheless, once selection effects are controlled for, an important incentive effect ("ex-post moral hazard") remains. A decrease in the copayment rate from 100% to 10% increases the marginal demand for health care by about 90% and from 100% to 0% by about 150%. The correlation between insurance coverage and health care expenditures may be decomposed into the two effects: 75% may be attributed to selection, and 25 % to incentive effects.Cet article propose une analyse de la demande jointe d'assurance maladie et de soins de santé. L'analyse développe un modèle structurel de demande jointe et ce modèle est estimé par maximisation de la vraisemblance totale, à partir de données administratives de remboursement des soins issues d'une caisse d'assurance maladie suisse couvrant 60000 adultes. La stratégie d'estimation s'appuie sur certains aspects institutionnels du système d'assurance maladie suisse, dans lequel chaque individu peut choisir son niveau de couverture au sein d'un menu défini par la loi. L'analyse empirique met en évidence la présence de forts effets de sélection, les individus qui anticipent des dépenses élevées ayant tendance à s'assurer davantage. Toutefois, en contrôlant ces effets de sélection, un important effet d'incitation (" aléa moral ex post ") demeure. Une augmentation du taux de couverture de 0 à 90% conduit à une augmentation de la demande marginale de soins de l'ordre de 90%, et une prise en charge complète à une augmentation de l'ordre de 150%. La corrélation entre niveau d'assurance et montant des dépenses peut être attribuée pour 75% aux effets de sélection et pour 25% aux effets d'incitation

Simulation-Based Finite-Sample Normality Tests in Linear Regressions

In the literature on tests of normality, much concern has been expressed over the problems associated with residual-based procedures. Indeed, the specialized tables of critical points which are needed to perform the tests have been derived for the location-scale model; hence reliance on available significance points in the context of regression models may cause size distortions. We propose a general solution to the problem of controlling the size normality tests for the disturbances of standard linear regression, which is based on using the technique of Monte Carlo tests

Immigration 2030: Szenarien für die Zürcher Wirtschaft und Gesellschaft

Inhaltsverzeichnis: 1 Einleitung; 2 Zukünftige Zuwanderung; 2.1 Was lässt sich beobachten?; 2.2 Was ist der Motor der Migration?; 2.3 Modellierung der künftigen Migrationsströme; 2.4 Resultate zur Immigration 2030; 3 Wirtschaftliche Auswirkungen der Migration; 3.1 Auswirkungen auf Arbeitslosigkeit und Löhne; 3.2 Steuereinnahmen und Sozialausgaben

Prognose Gesundheitsberufe Ergotherapie, Hebammen und Physiotherapie 2025

Im Unterschied zur Pflege ist der zukünftige Bedarf an Fachpersonen der Gesundheitsberufe Ergotherapie, Hebammen und Physiotherapie in der Schweiz noch nicht untersucht worden. Diese Studie entwickelt Prognoseszenarien sowohl auf der Grundlage von Statistiken des Schweizer Gesundheitswesens als auch von Expertenwissen. Der Bericht zeigt, dass in allen drei Berufen eine deutliche Zunahme des Bedarfs an Fachpersonen bis 2025 zu erwarten ist. Ob der steigende Bedarf gedeckt werden kann, hängt insbesondere von der zukünftigen Zahl der Fachhochschulabsolventen/-innen und vom Ausmass der Arbeitsmigration ab