Swiss hospital planning: SNSF funds HSG project with close to half a million francs

With hospital reform in Switzerland in 2012, hospital financing was also reorganized. Since then, the range of services has been offered by the 278 hospitals in Switzerland (as of 2022) has been structured by a planning system that has been gradually introduced. Healthcare services are remunerated using flat rates per case. There is still little information available on the effectiveness of this method, particularly with regard to care structures, quality and costs. The project approved by the Swiss National Science Foundation (SNSF) aims to clarify this. The title of the project is: “The Swiss hospital capacity planning: An empirical evaluation of its impact on hospital service delivery, quality and costs”. The team from the Chair of Health Economics, Policy and Management at the University of St.Gallen is led by Prof. Dr. Alexander Geissler.

Goal: Gaining insight for healthcare policy

The overarching aim of the research project is to gain a detailed understanding of the effects of hospital planning on service provision, quality and costs. To this end, six selected diagnoses and treatments are examined: stroke, knee replacement, colon surgery, childbirth, oesophageal resection and pancreatic resection. The empirical analysis combines various quality, cost and performance data sets. The results should provide valuable insights for healthcare policy and contribute to the formulation of effective strategies for quality improvement and cost control in the Swiss healthcare system and beyond. The project answers the following questions, among others:

• Has the new method of capacity planning in hospitals led to centralization? Has it influenced market concentration? Has it led to a redistribution of complex care to centres and basic care to cantonal or regional hospitals? Does this effect the level of quality requirements?
• Has the new method led to higher quality (for complex treatments)?
• Has the new method dampened the rise in costs in the hospital sector?

Scientific and social context

News about the financial imbalance of hospitals or the cost explosion in the healthcare sector is becoming more frequent. In many places, taxpayers have had to spend considerable sums to stabilize hospitals economically. In view of the cantonal differences in implementation, the analyses of the SNSF project will reveal the most important factors for the success or failure of the 2012 reform. The results of the study are relevant not only for Switzerland, but also for other countries with similar systems.

Image: Adobe Stock / sudok1