An empirical investigation of the efficiency effects of integrated care models in Switzerland

<p><strong>Introduction:</strong> This study investigates the efficiency gains of integrated care models in Switzerland, since these models are regarded as cost containment options in national social health insurance. These plans generate much lower average health care expenditure than the basic insurance plan. The question is, however, to what extent these total savings are due to the effects of selection and efficiency.</p><p><strong>Methods:</strong> The empirical analysis is based on data from 399,274 Swiss residents that constantly had compulsory health insurance with the Helsana Group, the largest health insurer in Switzerland, covering the years 2006 to 2009. In order to evaluate the efficiency of the different integrated care models, we apply an econometric approach with a mixed-effects model.</p><p><strong>Results:</strong> Our estimations indicate that the efficiency effects of integrated care models on health care expenditure are significant. However, the different insurance plans vary, revealing the following efficiency gains per model: contracted capitated model 21.2%, contracted non-capitated model 15.5% and telemedicine model 3.7%. The remaining 8.5%, 5.6% and 22.5% respectively of the variation in total health care expenditure can be attributed to the effects of selection.</p><p><strong>Conclusions:</strong> Integrated care models have the potential to improve care for patients with chronic diseases and concurrently have a positive impact on health care expenditure. We suggest policy makers improve the incentives for patients with chronic diseases within the existing regulations providing further potential for cost-efficiency of medical care.</p

Legislation of direct-to-consumer genetic testing in Europe: a fragmented regulatory landscape

Despite the increasing availability of direct-to-consumer (DTC) genetic testing, it is currently unclear how such services are regulated in Europe, due to the lack of EU or national legislation specifically addressing this issue. In this article, we provide an overview of laws that could potentially impact the regulation of DTC genetic testing in 26 European countries, namely Austria, Belgium, Cyprus, the Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, the Netherlands and the United Kingdom. Emphasis is placed on provisions relating to medical supervision, genetic counselling and informed consent. Our results indicate that currently there is a wide spectrum of laws regarding genetic testing in Europe. There are countries (e.g. France and Germany) which essentially ban DTC genetic testing, while in others (e.g. Luxembourg and Poland) DTC genetic testing may only be restricted by general laws, usually regarding health care services and patients’ rights

Are Pain and Suffering Awards (Un-)Predictable? Evidence from Germany

This paper assesses the widely held belief that damages for pain and suffering are random or arbitrary. In detail, we investigate whether damages for pain and suffering are systematically affected by individual-, injury- and procedural-specific characteristics and how important these factors are relative to each other. To uncover the predictability of these awards, we rely on a sample of German damages for pain and suffering awards including 2.244 verdicts. By estimating a standard regression model we observe that final awards are systematically influenced by the injury’s conditions, by the court level the case is brought in and by the engagement of a lawyer. Our findings let us conclude that damages for pain and suffering and the respective assessment process within the German judicial system are largely reasonable and transparent rather than random

Doping Sanctions in Sport: Knowledge and Perception of (Legal) Consequences of Doping&mdash;An Explorative Study in Austria

Anti-doping rule violations (ADRVs) can lead to sports-related and legal sanctions, thus, being knowledgeable is important. Research into this knowledge and how athletes and their support personnel (ASP) perceive the control mechanisms and the appropriateness of (legal) sanctions is still scarce. This explorative study aimed to examine the knowledge and perception of existing (legal) sanctions in Austria, by distributing a questionnaire to Austrian athletes and ASP covering the topics of knowledge related to legal and sports-related consequences associated with a specific ADRV presented in a case study, their trust and satisfaction with specific agencies (based on the European Social Survey (ESS)) and perceived efficiency and effectiveness of the doping control system. Data were analyzed descriptively. All respondents (N = 59) agreed on a ban from sport to be appropriate. Knowledge about legal consequences and the trust in the judiciary and the sport governing bodies was moderate (6.82 out of 10). Perceived appropriate consequences were on average higher than the likely sanctions to be faced. Future prevention should include trust building measures in the institutions and the control system, improvement in terms of access to law and education for the target group and critical reflection on the existence of social norms. Furthermore, the implementation of risk management aspects should be part of future approaches

Additional file 1 of Attitudes of European students towards family decision-making and the harmonisation of consent systems in deceased organ donation: a cross-national survey

Additional file 1