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Contribution Details

Type Master Thesis
Scope Discipline-based scholarship
Title Improving Swiss Health System by shifting the spending to the primary care concept
Organization Unit
Authors
  • Diego Favre
Supervisors
  • Pablo Koch Medina
Language
  • English
Institution University of Zurich
Faculty Faculty of Business, Economics and Informatics
Number of Pages 73
Date July 2019
Abstract Text Switzerland is amongst the most developed countries in the world. This is re- ected in its high quality of healthcare. However, if healthcare costs continue to increase the costs supported by the inhabitant may become unsustainable. Consequently, the system must be reformed but how? Some countries ap- pear to be more ecient than Switzerland, one of them is Sweden. Therefore, mimicking some ideas from Sweden could o er good ideas on how best to re- form the Swiss health system. First, we had identi ed whether the countries were comparable. A PESTEL analysis was used to highlight common points and the di erences. It helped to make a thorough description of the two countries and their health systems. Furthermore, it provided some di er- ences between the two health systems that were used to assess the potential improvements that could possibly be implemented in Switzerland. The health system has been the topic of many studies. Therefore, the anal- ysis and the adaptation of their results to the Swiss system was the second step of this thesis. This identi ed some key areas in which the Swiss health system could be improved. Switzerland is still based on a stationary care concept because of the low incentives to turn to ambulatory care. Introducing more ambulatory care could save 1 billion CHF per year according to a PWC study. However, those savings should be used for the change of cost gravity to primary care. Indeed, the development of primary care is almost an obligation nowadays with the ageing population and the growth of chronic diseases. Primary care is more ecient in dealing with chronic diseases and multi-comorbidity fac- tors. By identifying patients at an early stage, it could prevent unnecessary hospitalisation and therefore decrease the numbers of beds by inhabitants. Reaching the same eciency as Sweden in terms of cost per bed per inhab- itant could save about 2.7 billion CHF per year. Primary care also focuses on better coordination between the di erent stakeholders in the health sys- tem. The development of new technologies allowing the digitalisations of the health system would empower patients and highlight any ineciencies in the system. It would also enable the implementation of a pay-for-performance pricing system that could persuade stakeholders to choose the most ecient solutions in term of cost and quality of healthcare. Furthermore, a more ecient generic penetration with compulsory usage would save about 1.7 billion CHF if Switzerland reaches the same market penetration as Sweden. One billion more could be saved if the price of generic medicines was the same as bordering countries. Finally, amalgamating all of these savings could allow Switzerland to save more than 5 billion CHF per year. In conclusion, optimistic projections made 1 by the Federal Oce of Statistic in 2007 predicted that the health expendi- ture would be between 111 billion and 128 billion CHF in 2030, in the best scenarios. Unfortunately, this best scenario now seems dicult to attain if the health expenditures keeps increasing at the same rate. It would probably be higher than 130 billion CHF without considering the ageing population and their associated costs. However, several measures can be implemented to slow the pace of the increasing costs. We have seen that by mimicking Swedish ideas, Switzerland could potentially save more than 5 billion per year and that the development of primary care and the use of digitalisation could substantially increase those savings in the future. Politicians are aware of the future challenges to the health system. Therefore, they need to re- form the health system in order to make it sustainable and ecient in the long-term.
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