Letter in response to the article published by O. Reich, R. Rapold and M. Flatscher-Thöni. An empirical investigation of the efficiency effects of integrated care models in Switzerland

The paper by Reich et al. recently published in the IJIC compares healthcare expenditure of patients insured in a contracted capitated model, a contracted non-capitated model, and a telemedicine model [1]. Their evaluation showed that the telemedicine model was associated with an efficiency gain of 3.7% as opposed to 21.2% for the contracted capitated and 15.5% for the non-capitated model. The analyses were restricted to persons who claimed reimbursement for health care expenses during the study period. As the authors themselves state, this restriction is a potential source of bias, which we believe has major implications for the interpretation of the study results.