Accepted for/Published in: JMIR Formative Research
Date Submitted: Jun 18, 2025
Date Accepted: Dec 17, 2025
Financial Burden and Chronic Illness in Switzerland: Using Natural Language Processing and Topic Modeling on a Large Corpus of Qualitative Interview Data
ABSTRACT
Background:
Chronic illness may cause a financial burden that affects patients, their caregivers and families. While international research, mostly from US America, has largely focused on cancer-related financial hardship, less is known about whether financial distress due to other chronic illness exists, specifically in countries which have a universal health insurance coverage such as Switzerland.
Objective:
The objective is to provide insights into how financial burden is discussed by individuals living with chronic illness in Switzerland.
Methods:
Based on a Natural Language Processing approach, alongside topic modeling, a secondary analysis of 180 qualitative interviews of individuals living with chronic illness (dementia, chronic pain, multiple sclerosis, Parkinson’s disease, and rare diseases) from the Swiss Database of Individual Patient Experiences was conducted.
Results:
Key categories identified were money issues, insurance-disability, general insurance concerns, and work and loss of income. Individuals living with dementia and Parkinson’s disease appear to be more concerned with money issues, whereas people living with chronic pain, multiple sclerosis and rare diseases likely are more burdened by insurance related concerns, specifically disability insurance related challenges. Bureaucratic hurdles and employment instability appear to contribute to the financial burden of people living with chronic illness in Switzerland.
Conclusions:
Financial burden appears to be a complex issue among individuals living with chronic illness in Switzerland. Therefore, policy measures should aim at systemic reform, particularly around insurance eligibility, employment flexibility, and the mitigation of out-of-pocket costs, to enhance financial stability and quality of life for affected individuals.
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Copyright
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