Service-, needs-, and quality-based hospital capacity planning – The evolution of a revolution in Switzerland

Elsevier

Available online 25 September 2022

Health PolicyHighlights•

Main objective is the provision of needs-based, high-qualitative efficient health care

The model is based on a classification system of service groups

All three inpatient areas are included: acute, psychiatry, and rehabilitation

The political process is highly transparent and participative, including all actors

Hospitals must apply for permission to provide service groups

Abstract

Most developed countries spend a large amount of their health budget on hospital capacities and inpatient services. However, those capacities and services are often not comprehensively planned what leads to vague service delivery steering and non-need driven hospital facilities. Switzerland is different as the planning procedure was completely reformed in 2012 and is further refined in 2021/2022. The Canton of Zurich, the frontrunner in Switzerland, has made a comprehensive update of its hospital capacity planning model for acute, psychiatric, and rehabilitative care. The result of this model is the hospital list. This list includes all hospitals which fulfil predefined quality, efficiency, and need requirements. Hospitals on the list receive a mandate to provide inpatient treatments for specific and selected service groups (n=196), clustered in three areas (acute care, psychiatry, rehabilitation). The underlying health care policy process is transparent and is characterized by a high participation of all relevant actors. The building blocks of the planning model are a classification system of service groups, different quality and efficiency requirements attached to these groups, and an analysis of current and future need for health care. Hospitals which are willing to perform services must apply and demonstrate that the requirements are fulfilled. The Canton then decides needs-based which hospital can deliver which services.

Keywords

Health policy

Needs-based hospital planning

Hospital service classification system

Health care quality

Delivery of health care

Inpatient health care

© 2022 The Authors. Published by Elsevier B.V.

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