title: Understanding recent trends in Swiss ambulatory care utilization when out-of-pocket payment is minimal.
abstract: OBJECTIVE
  To examine trends in ambulatory care utilization when individuals face almost no financial barriers to health care.
  
  
  METHODS
  Observational study of insurance data. Adults with minimal deductible were included. Ambulatory care visits and costs were measured from 1997 to 2002.
  
  
  RESULTS
  Mean ambulatory care costs/insuree increased from 1292.- to 1790.- CHF, corresponding to higher increases in drug costs (+61.7 %) than services costs (+24.3 %). The proportion of visits to generalists decreased while those to hospital outpatient services increased.
  
  
  CONCLUSIONS
  In a demographically stable population of insurees, increases in ambulatory care costs were due neither to growth in physicians' visits nor to increasing physicians' fees per act, but to what was included in or prescribed during the visits.
authors.affiliation: Health Services Research Unit, University Institute of Social and Preventive Medicine, Lausanne, Switzerland. Isabelle.Peytremann-Bridevaux@hospvd.ch
authors.forename: I
authors.initials: I
authors.lastname: Bridevaux Peytremann
authors.forename: B
authors.initials: B
authors.lastname: Santos-Eggimann
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000191:economics / Q000706:statistics & numerical data*; D016527:Drug Costs; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D013557:Switzerland