The use of pediatric health care services in Switzerland : a claims data analysis (preliminary results)

Exposure to unfavorable circumstances in childhood has been shown to have negative implications on physical, cognitive and psychological health in adulthood. Health problems in childhood should, therefore, be detected and treated at an early stage. Adequate pediatric health care, and in particular, preventive pediatric health screenings, play a key role in this context. In Switzerland, children and adolescents from 0-14 years are recommended to go through ten preventive health screenings. These screenings are performed at the parents’ initiative by the pediatrician or family doctor, except for two to three compulsory screenings at around the age of 6, 10 and 14 years, which are typically performed by the school medical services. However, little is known about the extent to which these screenings are performed and about potential barriers limiting the utilization of health care services. The aim of our study is to evaluate children’s access to adequate health care in Switzerland. In particular, we aim to identify potential inequalities in the use of pediatric health care between socioeconomic groups. We employ two strategies: a) Using data from the school medical services in the city of Bern, we assess the extent of foregone pediatric health care in different socioeconomic groups by evaluating the incidence of untreated or inadequately treated health problems. b) Using claims data from a large Swiss health insurer, we assess the health care utilization patterns throughout childhood and the extent to which preventive health screenings are performed. The identification of groups at risk of inadequate health care and a better understanding of the underlying mechanisms can contribute to improving access to preventive health care services and, hence, to reducing health inequalities in childhood