The quality of medical services still plays far-too-little a role in the Swiss healthcare system. But some stakeholders want to change that.
Such headlines are likely to be more frequent in the future. “The Schulthess Clinic’s high level of specialization and great experience directly benefit patients,” one of Switzerland’s best-known orthopedic clinics recently announced.
The data in the Swiss implant register, Siris, showed it: Within two years after a hip or knee prosthesis operation, significantly fewer patients needed a revision operation at the Schulthess Clinic than on average across Swiss clinics, it continued.
High case numbers
Every year, several thousand prostheses are implanted in Switzerland. These now include more than 21,000 hip prostheses and nearly 20,000 knee prostheses.
Of these, around 1,200 hip prostheses and around 850 knee prostheses are implanted each year at the Schulthess Clinic alone, which means that the hospital has the highest number of hip prostheses and the second-highest number of knee prostheses in the country.
Schulthess Clinic in front
What you do more often, you certainly do more routinely and better. And it is precisely this routine that apparently pays off not only for the highly specialized surgeons, but also for the entire procedures.
Thanks to the national Swiss implant register Siris, data on the complication rate of individual hospitals and implants can now be monitored and even compared.
For example, the Schulthess Clinic, which was founded back in 1883, showed a significantly lower 2-year revision rate for hip and knee prostheses than the Swiss average in the publicly available report.
Quality must be known
This rate was 1 percent for hip replacements and 1.1 percent for knee replacements at Schulthess Clinic. This is over two and a half times and over three times lower, respectively, than the Swiss average.
Switzerland averages 2.6 percent for hip replacements and 3.4 percent for knee replacements. Data from 2016 to 2019 were evaluated.
With over 9,600 surgeries and over 131,400 outpatient contacts, this medical facility is not for nothing one of the leading clinics for treatments on the musculoskeletal system in Europe.
According to the study, the quality is much better, and this is probably due in large part to the fact that the procedures are performed more frequently than elsewhere.
Insurer moves ahead
It is precisely in this direction of quality that Groupe Mutuel, a health insurer based in French-speaking Switzerland, wants to develop the Swiss healthcare system.
In fact, in order to get costs under control in the Swiss healthcare system, Groupe Mutuel is pushing ahead with the “pay for quality” approach, as the health insurer recently explained to the media, including muula.ch.
Among other things, this involves only paying for medical services in full if the quality is right and the patient is satisfied. The service providers, such as hospitals and doctors, have little responsibility, it said.
A representative survey by Groupe Mutuel showed that patients were being “treated over their heads”. According to the survey, almost two-thirds of respondents had never been asked about their own satisfaction with the outcome of treatment. Among patients aged 30 to 44, the figure was nearly three-quarters.
Markdowns for worse
The specialization and experience of the Schulthess Clinic, for example, are clearly reflected in these official quality figures. This should therefore also be reflected in the remuneration for services.
It is true that no higher tariffs should be paid, because the Swiss healthcare system has to save money. But it should lead to discounts for the demonstrably worse performers, which would be an absolute novelty.
The headlines about the quality successes of service providers should therefore make the rounds much more in the future.