Does the chronically ill population in the Netherlands switch their health insurer as often as the general population? Empirical evidence from a nationwide survey study

W. van der Schors, A.E.M. Brabers*, J.D. De Jong

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background Consumer mobility is an important aspect of a health insurance system based on managed competition. Both the general population and insured with a chronic illness should enjoy an equal opportunity to switch their insurer every year. We studied possible differences in the rates of switching between these two groups in the Netherlands. Methods A structured questionnaire was sent to 1500 members of Nivel's Dutch Health Care Consumer Panel (response rate: 47%) and to 1911 chronically ill members of the National Panel of the Chronically ill and Disabled (response rate: 84%) in February 2016. Associations between switching and background characteristics were estimated using logistic regression analyses with interaction effects. Results In general, we did not find significant differences in switching rates between the general population and chronically ill population. However, a combination of the population and background characteristics demonstrated that young insured with a chronic illness switched significantly less often than young insured from the general population (1% versus 17%). Conclusions Our results demonstrated that the group of young people with a chronic illness is less inclined to switch insurer. This observation suggests that this group might either face difficulties or barriers which prevents them from switching, or that they experience a high level of satisfaction with their current insurer. Further research should therefore focus on unravelling the mechanisms which explain the differences in switching rates.
Original languageEnglish
Article number376
Number of pages11
JournalBMC Health Services Research
Issue number1
Publication statusPublished - 5 May 2020


  • behavior
  • choice
  • chronic disease
  • consumer mobility
  • determinants
  • elasticities
  • germany
  • health insurance
  • health system reform
  • insurance
  • managed competition
  • markets
  • price
  • quality
  • regulated competition
  • switching
  • Choice
  • Health system reform
  • Health insurance
  • Chronic disease
  • Switching
  • Managed competition
  • Consumer mobility

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