Study Shows: Switzerland Plans Its Hospitals Without Public Involvement

Hospitals in Switzerland face significant challenges: rising costs, underperforming facilities, staff shortages, and increasing outpatient care. Hospital planning based on cantonal boundaries is reaching its limits. Although Parliament, the federal government, and the Conference of Cantonal Health Directors (GDK) have recognised the need to address this issue, concrete proposals and in- depth consideration of the actual circumstances are still lacking.

The University of St. Gallen, commissioned by the Fondation Groupe Mutuel, analysed Switzerland's hospital landscape. It shows that cantonal planning boundaries have little to do with actual healthcare provision for many service groups. In a majority of the regions studied, 25 to 50 percent of the population receive treatment outside their canton. In some areas, such as Mesocco GR, this accounts for 95% of cases. This applies to both general inpatient care and elective procedures.

Non-cantonal patients systematically accept longer travel distances. They focus not on the proximity of a hospital, but on its quality, expertise, and language, as the study reveals. 'Inter-cantonal care is not a niche issue of highly specialised medicine but a reality for many general care treatments. Planning should reflect these circumstances. Furthermore, service groups should be reviewed regarding urgency and complexity, and based on this, planning levels from local to national should be defined,' explains Prof. Dr. Alexander Geissler, Professor of Health Economics, Policy, and Management and co-author of the study.

Further analysis of hospital occupancy shows overlap in the service mandates of neighbouring cantons. In most cantons, one-third to four-fifths of hospitals provide 80%-90% of the treatments in a service group.

'Patient reality shows that the image of the local 'community hospital' is outdated. We need to move away from the self-interests of the cantons in hospital planning and focus on the interests of the patients,' demands Thomas Boyer, CEO of Groupe Mutuel.

Groupe Mutuel aims for comprehensive care planning with a focus on quality. As highlighted in the study, service groups should be assigned to the appropriate level. Besides existing planning levels from the federal government and cantons, 5 to 7 regional health regions could ensure greater efficiency. Additionally, quality indicators in terms of value-based healthcare and minimum case numbers must be considered. At the same time, community-based outpatient care should also be included in the planning.

'We need to shift from hospital planning to care planning. The study shows that, alongside highly specialised medicine at the federal level, we can best accommodate real patient flows with inter-cantonal health regions. Furthermore, we must include local primary care in the planning,' says Thomas Boyer.

Media Contact:
Lisa Flückiger, Media Spokesperson for German-speaking Switzerland
Tel. 058 758 90 04 – Mobile 079 534 77 26, lflueckiger@groupemutuel.ch

Editor's note: Image rights belong to the respective publisher. Image rights: Groupe Mutuel