the
A visual reflection on four challenges in
healthcare system Perspective
Demographic and social changes
Switzerland’s population is steadily aging 1 . This is affecting the demand for elder care and long-term care – in both institutional and home settings. In 2011, long-term care services were provided to 205,134 persons, according to Spitex, the Swiss federation of home care and assistance providers. This figure rose to 404,916 in 2022 2. The shift from outpatient to inpatient care and older persons’ desire to stay in their own homes for as long as possible is set to increase demand for home care services even further – and not only for older persons 3 . The trend is clear: the importance of care and assistance in the home will continue to increase. In the SCDH’s realistic testing spaces, the optimal set-up for these services can be researched, developed and tested.
1 Bundesamt für Gesundheit (BAG). (2019). Die gesundheitspolitische Strategie des Bundesrates 2020–2030. BAG.
2 Bundesamt für Statistik. (2022). Hilfe und Pflege zu Hause, 2011–2022 [data record]. Bundesamt für Statistik. https://www.bfs.admin.ch/bfs/ de/home/statistiken/gesundheit/gesundheitswesen/hilfe-pflege-hause. html#par_text (source for graphic)
3 Pellegrini, S., Dutoit, L., Pahud, O. & Dorn, M. (2022). Bedarf an Alters- und Langzeitpflege in der Schweiz. Prognose bis 2040. (Obsan Bericht 03/2022). Schweizerisches Gesundheitsobservatorium (Obsan).
Women
Total: 132,570
Aged 0–19
Aged 20–64
Aged 65–79
Aged 80+
Men
Aged 0–19
Aged 20–64
Aged 65–79
Aged 80+
Total: 72,564
2011 2011 2012 2012 2013 2013 2014 2014 2015 2015 2016 2016
Total: 220,972
Recipients of long-term home care and assistance services, by sex and age group, 2011–2022
2017 2017 2018 2018 2019 2019 2020 2020 2021 2021 2022 2022 Total:
183,944
Technological and digital transformation
Technological advances affect the population by improving the chances that people can lead healthy lives based on self-determination 1. Switzerland has not yet taken advantage of the opportunities that digitalisation offers health systems to the same degree that some other countries have. It is true that some progress has been made in the area of remote consultations and in connection with the standard electronic health record – known in this country as the electronic patient record – but the use of these innovations has been very limited thus far. Moreover, when it comes to the remote monitoring of chronically ill persons, to tools that chronically ill people can use to manage their own illnesses, or to e-prescriptions, the few products that are out there are only initial, not yet mature solutions 2 . By involving all users in the development process, the SCDH helps partners from industry and scientific institutions to develop technologies that will be broadly accepted and used.
1 Bundesamt für Gesundheit (BAG). (2019). Die gesundheitspolitische Strategie des Bundesrates 2020–2030. BAG.
2 McKinsey Digital. (2021). Digitalisierung im Gesundheitswesen: Die 8,2-Mrd.-CHF-Chance für die Schweiz. McKinsey. (source for graphic)
B Remote monitoring of chronically ill patients
C Self-management tools for persons with chronic illnesses
D Standard electronic health records
E E-prescriptions
Level of maturity
CH CH CH CH CH IT IT IT IT IT FI FI FI FI FI DE DE DE DE DE CA CA CA CA CA NL NL NL NL NL UK UK UK UK UK PL PL PL PL PL SE SE SE SE SE A Remote consultations Technology
1 2 3 4 5
Inter-country comparison of maturity of five different technologies in the health sector
Level of maturity (status quo)
1 Not at all
2 Initial, still immature solutions exist, e. g. pilot projects
3 Some level of maturity, e. g. solutions exist but there is no large-scale implementation
4 Very mature solutions implemented with high levels of acceptance
5 Highest level of maturity
Switzerland
Other countries:
CA – Canada
DE – Germany
FI – Finland
IT – Italy
NL – The Netherlands
PL – Poland
SE – Sweden
UK – United Kingdom
Opportunities for a healthy life
Full-time employees in Switzerland missed an average of 9.3 days of work due to illness in 2022. This is a new all-time high. The increase in absences appears across all sectors, including “health and social services”. Absence rates have been on the rise in this sector since 2010. The Federal Statistical Office does not identify the reasons for the increased incidence of absences 1 . According to the document detailing the 2020–2030 federal health strategy, numerous factors can impact human health, with the environment and work being among the most influential of these. For instance, there are pollutants in the air, water and soil that pose health risks. Unfavourable working conditions can also have detrimental effects on people’s health 2. The SCDH gives manufacturers and employers the opportunity to perform tests in realistic settings to assess working places and/or their furnishings intended to benefit health.
1 Bundesamt für Statistik. (2022). Arbeitsvolumenstatistik (AVOL), 2010–2022 [data record]. Bundesamt für Statistik. https://www.bfs.admin.ch/bfs/de/ home/statistiken/arbeit-erwerb/erhebungen/avol.html (source for graphic) 2 Bundesamt für Gesundheit (BAG). (2019). Die gesundheitspolitische Strategie des Bundesrates 2020–2030. BAG.
1.5 2.0 2.5 3.0 3.5 4.0 4.5 5.0 5.5 Ratio in % Total Average Sex Men Women Nationality Swiss citizens Non-Swiss citizens Age group Aged 15–24 Aged 25–34 Aged 35–44 Aged 45–54 Aged 55–64 Skilled agricultural, forestry workers Technicians and associate professionals Professionals Managers Company size 1–9 employees 10–49 employees 50–99 employees 100–249 employees 250+ employees Economic sector Agriculture and forestry Financial and insurance sector Professional, scientific and technical services Arts, entertain., priv. households, other services Information and communication Manufacturing/Energy supply Public administration Trade, repair business Accommodation and food service Human health and social work activities Real estate and other economic services Construction Transportation and storage Clerical support workers Elementary occupations Craft and related trades workers Services and sales workers Plant and machine operators and assemblers Major occupational group
2022 2010 Percentage change
Health-related workplace absences of full-time employees 2010–2022
High-quality, affordable care
The Swiss population has access to a high-quality health care system. This system is under pressure, however. The costs of healthcare in Switzerland are rising every year, and they are already very high when compared to those in other countries 1. Meanwhile, a shortage of qualified personnel poses a risk for the quality of care 2. Switzerland’s hospitals already rely on personnel from other countries to keep themselves fully staffed. Every third person who works in a hospital or clinic is from another country. The percentage is highest among doctors, 45 percent of whom are not Swiss. Non-Swiss employees account for 34 percent of nursing and care personnel 3. Action will be needed on several different fronts to counter the skills shortage. One of these is the design of the work environment. The SCDH team works with hospital personnel to develop and evaluate architectural and digital solutions and products for health institutions. The result: increased levels of acceptance, occupational safety and satisfaction.
1 Bundesamt für Gesundheit (BAG). (2019). Die gesundheitspolitische Strategie des Bundesrates 2020–2030. BAG.
2 Golder, L., Jans, C., Pepe, A., Schäfer, S., Pagani, A. & Bohn, D. (2023). Brennpunkt Versorgungsqualität. Fachkräftemangel und zunehmender Einfluss nicht kurativ tätiger Akteure sichtbar. Studie im Auftrag der FMH. gfs.bern. 3 Bundesamt für Statistik. (2023). Krankenhausstatistik. [data record]. Bundesamt für Statistik. https://www.bfs.admin.ch/bfs/de/home/statistiken/ gesundheit/erhebungen/ks.html (source for graphic)
1 2 4 Nursing and care personnel 96,518 Administrative personnel 38,819
Hospital personnel, by role and origin, 2022
Nursing and care personnel
1 Registered Nurses, Advanced Federal Diploma of Higher Education
2 Registered Nurses, Advanced Federal Diploma of Higher Education, with specialisation
3 Nursing and care staff with upper secondary qualification
4 Other nursing and care staff
5 Assistant-level nursing and care staff
6 Midwives
Doctors
7 Early-career doctors training in specialty
8 Practising specialists with training responsibility
9 Heads of units, practising specialists
10 Final-year medical students working in clinical-elective position
11 Heads of departments, practising specialists with additional advanced qualification
12 Practising specialists with no training responsibility
Medical technical personnel
13 Medical radiographers
14 Medical technical personnel with upper secondary qualification
15 Biomedical scientist
16 Academic staff
17 Specialists in surgical technology
18 Paramedics
19 Emergency medical technicians
Medical-therapy personnel
20 Physiotherapists
21 Psychologists
22 Occupational therapists
23 Dietitians
24 Other therapists
25 Medical therapy personnel with upper secondary qualification
26 Mobilization therapists
27 Speech therapists
28 Medical massage therapists
3 7 9 10 11 12 13 15 17 20 21 16 14 8 5 6 18 22 23 24 25 26 27 28 19 Swiss citizens Non-Swiss citizens
Doctors 33,951 Housekeeping personnel 24,345 Technical services 5426 Medical technical personnel 19,597 Medical-therapy personnel 15,309 Social services 3089
Switzerland has a high-quality health care system. It is a system that is facing a number of big tasks and changes, though. The Swiss Federal Council identifies the four most pressing challenges in its “Health2030 Strategy”.
The design agency Hahn+Zimmermann has created an informational graphic from its “Perspective” for each challenge. How should we meet these challenges in the future? The SCDH researches and develops possible approaches to them –because everyone should be able to live in an environment that benefits their health.
The “Perspective” is produced annually as part of the SCDH annual report.
Gender-sensitive language
The SCDH is committed to using gender-sensitive language. Gender-sensitive language depicts all persons on an equal basis, regardless of their biological sex or gender identity.
Imprint
Concept and design: Hahn+Zimmermann, Bern
Text: SCDH
Copy editing and translation: wordup GmbH, Nidau
Printing: Ediprim AG, Biel/Bienne
Font: GT Haptik
Paper: Z-Offset 170 g
The CO 2 emissions from the production of this “Perspective” were offset with MyClimate.
Contact
SCDH, Communication and Marketing Ipsachstrasse 16, 2560 Nidau info@scdh.ch