Search
Search

Health Systems and Policy Monitor (HSPM)

An innovative platform that provides a detailed description of health systems and provides up-to-date information on reforms and changes that are particularly policy relevant.
For detailed information on country policy responses to the COVID-19 pandemic during 2020-2021, see our separate COVID-19 Health Systems Response Monitor (HSRM).

obs-logo

Switzerland

Health Systems in Transition (HiT) profile

Menu

  1. Country Overview

  2. Health Systems in Transition (HiT) profile

    1. 1. Introduction
      1. 1.0. Introduction
      2. 1.1. Geography and sociodemography
      3. 1.2. Economic context
      4. 1.3. Political context
      5. 1.4. Health status
    2. 2. Organization and governance

      Updated: 18 July 2024
      1. 2.0. Introduction
      2. 2.1. Overview of the health system
      3. 2.2. Historical background
      4. 2.3. Organization
      5. 2.4. Decentralization and centralization
      6. 2.5. Planning
      7. 2.6. Intersectorality

        Updated: 18 July 2024
      8. 2.7. Health information management

        Updated: 30 May 2023
      9. 2.8. Regulation

        Updated: 12 August 2021
      10. 2.9. Patient empowerment
    3. 3. Financing

      Updated: 09 July 2024
      1. 3.0. Introduction
      2. 3.1. Health expenditure

        Updated: 06 June 2021
      3. 3.2. Sources of revenue and financial flows
      4. 3.3. Overview of the statutory financing system

        Updated: 09 July 2024
      5. 3.4. Out of pocket payments
      6. 3.5. Voluntary health insurance
      7. 3.6. Other financing
      8. 3.7. Payment mechanisms

        Updated: 01 January 2020
    4. 4. Physical and human resources

      Updated: 03 June 2019
      1. 4.0. Introduction
      2. 4.1. Physical resources
      3. 4.2. Human resources

        Updated: 03 June 2019
    5. 5. Provision of services

      Updated: 02 August 2022
      1. 5.0. Introduction
      2. 5.1. Public health
      3. 5.2. Patient pathways
      4. 5.3. Primary / ambulatory care
      5. 5.4. Specialized ambulatory care / inpatient care
      6. 5.5. Emergency care
      7. 5.6. Pharmaceutical care

        Updated: 02 August 2022
      8. 5.7. Rehabilitation / intermediate care
      9. 5.8. Long term care
      10. 5.9. Services for informal carers
      11. 5.10. Palliative care
      12. 5.11. Mental health care
      13. 5.12. Dental care
      14. 5.13. Complementary and alternative medicine
      15. 5.14. Health services for specific populations

        Updated: 01 March 2021
    6. 6. Principal health reforms

      Updated: 10 October 2022
      1. 6.0. Introduction
      2. 6.1. Analysis of recent reforms

        Updated: 10 October 2022
      3. 6.2. Future developments

        Updated: 24 May 2017
    7. 7. Assessment of the health system

      Updated: 22 October 2022
      1. 7.0. Introduction
      2. 7.1. Stated objectives of the health system
      3. 7.2. Financial protection and equity in financing

        Updated: 22 October 2022
      4. 7.3. User experience and equity of access to health care
      5. 7.4. Health outcomes, health service outcomes and quality of care
      6. 7.5. Health system efficiency

        Updated: 24 January 2022
      7. 7.6. Transparency and accountability
    8. 8. Conclusions
      1. 8.0. Introduction

2.6. Intersectorality

The Concept Note for the Development of Intersectoral Health Policies of the FOPH (FOPH, 2005) published in 2005 recognizes that national health policy should aim for better integration of health aspects in the policies of all relevant sectors. Also, the Federal Council’s Health2020 strategy (FDHA, 2013) mentions that health is influenced by education, social security, transport, the environment and income, as well as more general working and living conditions; and government departments should increase their collaboration to address these social determinants of health.

Improving population health is included as one of 10 action areas in the Federal Sustainable Development Strategy (2012–2015) (Federal Council, 2012b), which is currently being updated for the period 2016–2019 by the Federal Department of the Environment, Transport, Energy and Communications (DETEC). The strategy lists several ongoing intersectoral activities in the area of health. These include the National Programme for Nutrition and Physical Activity (2008–2012), involving the FOPH, the Federal Office of Sports, the Foundation Health Promotion Switzerland and the cantons; and the National Programme for Migration and Health (recently prolonged for 2014–2017), involving the FOPH, the State Secretariat for Migration and the GDK/CDS. The FOPH is also collaborating with multiple federal offices with the aim of developing public infrastructure that promotes physical activity.

Health is also taken into consideration by multiple policies in different areas. The Federal Office of Sports within the Federal Department of Defence, Civil Protection and Sport is promoting physical activity by coordinating sport programmes. The SECO within the Federal Department of Economic Affairs, Education and Research (EAER) is responsible for workplace health protection and prevention. The State Secretariat for Education, Research and Innovation (SERI), also within EAER, regulates the vocational and continuing training of non-academic health professions. Responsibility for food safety is split across several ministries, including the Federal Office for Agriculture within EAER and the FOPH.

However, permanent intersectoral structures do not exist at the federal level except for certain specific areas (e.g. substance abuse). Instead, intersectoral policies affecting the health sector are usually dealt with in ad hoc interministerial working groups. Health inequalities, which are affected by a wide range of social determinants, are mostly considered from the limited perspective of equity of access to health care services and the focus is mostly on migrant populations and gender (OECD/WHO, 2011).

Formal health impact assessments (HIAs) have not yet been institutionalized at the federal level, although some cantons (in particular Geneva, Jura and Ticino) have considerable experience with HIAs. A guide for HIAs was published in 2010 by the Swiss Platform for Health Impact Assessments and the Foundation Health Promotion Switzerland (GFA, 2010). The proposed Federal Prevention Law planned to introduce HIA at the federal level but was rejected by Parliament in September 2012 (see section 6.1). Currently, there are no plans for introducing formal HIA at the federal level.

The National Council approved on 7 March 2024 a sum of 392 million Swiss francs over 10 years for Digisanté, a program promoting digital transformation in healthcare (see “DigiSanté: Promoting digital transformation in healthcare” country update for more details). The bill then moved to the Council of States, which approved it on 29 May 2024.

The initial phase, ongoing until the end of 2024, focuses on laying the groundwork for a successful digital transformation by addressing current challenges. Around 50 different projects are grouped into four comprehensive packages of measures.

  1. Prerequisites for Digital Transformation: Establishing an essential foundation, including a broad strategy, legal and organizational frameworks, and a target architecture while maintaining data security.
  2. National Infrastructure: Developing infrastructure for secure and seamless data exchange, including registers, interfaces, and applications, while achieving legal interoperability across the data space.
  3. Digitizing Government Services: Improving the quality and efficiency of data exchange between authorities and healthcare providers, facilitating quicker data transmission for policymakers, and enhancing communication within the healthcare industry.
  4. Secondary Use for Planning, Management, and Research: Utilizing health data for planning and managing the healthcare system, enhancing access for researchers, and improving databases and analysis tools.
The implementation phase is scheduled for 1 January 2025.
Authors
Related Content
References
National Council approves multi-million-euro loan for digital healthcare. Accessed 16 July 2024.

In May 2022, the Federal Council instructed the Federal Department of Home Affairs (FDHA) to develop a program to promote digital transformation in healthcare. In response, the FDHA proposed DigiSanté, formulated by the Federal Office of Public Health (FOPH) and the Federal Statistical Office (FSO). The initial phase will last until the end of 2024, with full implementation aimed for 2034.

DigiSanté seeks to create an interoperable healthcare system based on a transparent data ecosystem that is accessible to all stakeholders, while upholding data protection standards. This initiative is part of the Health 2030 strategy, which aims to improve quality and efficiency of healthcare through seamless data exchange for treatment, billing, research, and administration purposes.

The key objectives of DigiSanté include establishing a foundation for digital transformation, coordinating efforts across stakeholders, standardizing secure and interoperable exchange of data, and revising legal frameworks to support these changes. The initiative will follow a step-by-step approach, aligning with the Digital Switzerland strategy and involving multiple projects coordinated by the federal government.

For more information on the implementation packages, see “DigiSanté: Implementation packages” country update.

Authors
Related Content
References
  1. Federal Office of Public Health. DigiSanté: Förderung der digitalen Transformation im Gesundheitswesen [DigiSanté: Promoting digital transformation in healthcare]. Accessed 10 July 2024. https://www.bag.admin.ch/bag/de/home/strategie-und-politik/nationale-gesundheitsstrategien/digisante.html
  2. Digital Switzerland Strategy. Design of programme to promote digital transformation in the healthcare sector – DigiSanté. Accessed 16 July 2024. https://digital.swiss/en/action-plan/measures
  3. Federal Office of Public Health. Ziele und Nutzen von DigiSanté. Faktenblatt DigiSanté [Goals and benefits of DigiSanté. Fact sheet DigiSanté]. Published online 2023. https://www.bag.admin.ch/bag/de/home/strategie-und-politik/nationale-gesundheitsstrategien/digisante.html
  4. Digital Switzerland Strategy. Digital Switzerland Strategy Overview. Accessed 16 July 2024. https://digital.swiss/en/strategy/strategie.html

Since 2020, the electronic patient records (synonymous to electronic health record, EHR) have been gradually introduced in Switzerland following the adoption of the Federal Act on Electronic Patient Records in 2017. Until spring 2020, hospitals, rehabilitation facilities, psychiatric hospitals and all new ambulatory physician practices were required to integrate relevant data into EHRs while nursing homes could gradually integrate them up until 2022. For patients, pharmacies and ambulatory providers, including medical practices, midwife practices and home care services, participation was so far voluntary. In French-speaking regions of Switzerland, 83% of the population opened an EH while in the German-speaking part and in Ticino only 14% and 3%, respectively, opened one.

How does the Swiss EHR work? 

Since 2022, people living in Switzerland have been able to open EHRs. EHR contain treatment-relevant documents and data such as medication lists, case reports or hospital discharge summaries. The data standardization provided by the EHR, particularly the structured exchange formats, allow providers to share information seamlessly. Patients can also upload documents to their EHR such as their living will, organ donor card or earlier medical results.

What are the proposed changes of the EHR Act? 

In 2023, the Federal Council initiated a consultation process of the Federal Act on the Electronic Health Record to promote its use and dissemination, which foresees the following measures:

  1. To extend the requirement to use EHR to all providers. The use of existing EHR and registration with an EHR provider will be mandatory for all health care providers while it only remains voluntary for all healthcare professionals who are not classified as service providers under the Health Insurance Act.
  2. With the intention to make the EHR a pillar of the healthcare system, EHRs will be created automatically and provided free of charge for all residents in Switzerland with mandatory or military health insurance. Each individual has the right to opt out and can decide which healthcare professionals have access to the record.
  3. The division of tasks and competencies between the federal government and the cantons. The financing of the ongoing development of EHR will be ensured by the federal level, while the financing of EHR providers will fall under the responsibility of the cantons. The latter would also need to ensure that at least one EHR provider is operating within their canton.
  4. As medical data stored in the EHR is of interest to researchers, an option for EHR holders to make their data available for research will also be included in the revised Act. Patients can also specifically exclude certain data that they do not want available for research.
The submission for comprehensive revision of the Act was referred for consultation on 28 June 2023. The consultation will run until 19 October 2023.
Authors
Related Content
References

Elektronisches Patientendossier. (n.d). Was kostet das EPD? [How much does the Electronic Patient Record cost?]. https://www.patientendossier.ch/eroeffnung/was-kostet-das-epd

Federal Office of Public health. (2023). Die Eidgenössische Qualitätskommission fördert Best Practices im Gesundheitswesen [The Federal Quality Commission promotes best practices in the healthcare sector]. https://www.bag.admin.ch/bag/de/home/das-bag/aktuell/medienmitteilungen.msg-id-96317.html

Federal Office of Public health. (2023). Weiterentwicklung des elektronischen Patientendossiers: Start der Vernehmlassung [Further development of the electronic patient record: Start of the consultation process]. https://www.bag.admin.ch/bag/de/home/das-bag/aktuell/medienmitteilungen.msg-id-92641.html

Federal Office of Public Health. (2023). Weiterentwicklung elektronisches Patientendossier [Development of the electronic patient record]. https://www.bag.admin.ch/bag/de/home/strategie-und-politik/nationale-gesundheitsstrategien/strategie-ehealth-schweiz/umsetzung-vollzug/weiterentwicklung-epd.html

Swiss Medical Association. (n.d.). Elektronisches Patientendossier (EPD) [Electronic Patient Record (EPR)]. https://www.fmh.ch/themen/ehealth/patientendossier.cfm

Subscribe to our newsletter

Sign Up