In 2019, Switzerland spent an estimated CHF 1.8 billion on prevention and health promotion (PHP). Between 2010 and 2019, this expenditure accounted for between 2.2% and 2.7% of all health care costs, placing Switzerland in the lower half of OECD states (OECD, 2019). The Confederation, cantons and communes bear around a third, the social insurances roughly a fifth of this expenditure (see “PHP expenditure by financing scheme” indicator).
With regard to services, around 15% of expenditure went on the organisation and management of state PHP efforts. 10.5% of funds were spent on addiction and NCD prevention projects in the cantons and communes, 9.7% for health care in schools, 8.6% for food security and 6.1% for the prevention of occupational accidents and diseases as well as recreational accidents. The category “other prevention” accounted for the largest share of total PHP expenditure, with 50%. More than 200 civil health organisations provide a wide range of prevention and health promotion services. The financial volume of this category of services underlines the important role of private stakeholders in prevention and health promotion in Switzerland.
This indicator is part of the Monitoring System Addiction and NCD (MonAM) of the Federal Office of Public Health (FOPH).
Healthy ageing is an important objective of the Federal Council’s Health 2030 Strategy. People of all age groups should encounter conditions favourable to a healthy life. This should also allow the unfavourable cost trend in the health care system to be curtailed. Investments in prevention and health promotion services make an important contribution towards achieving these goals. The range of services in Switzerland is broad and very diverse:
- Addiction and NCD prevention: This category includes early diagnosis, advice, treatment and harm reduction with regard to alcohol, drugs or medication, measures for nutrition, exercise and mental health, education and training of PHP professionals, projects for children and young people, such as the “OpenSunday” or “MidnightSports” programmes or the participation of schools in the Swiss “Health Behaviour in School-aged Children” study.
- Health care in schools: This category includes the organisation of preventive measures in the school setting such as dental check-ups, vision and hearing tests, and vaccination monitoring.
- Accident and injury prevention: This category encompasses efforts to prevent occupational accidents and diseases in many businesses as well as the prevention of non-occupational accidents or recreational accidents.
- Food security: The inspection of businesses or laboratory testing come under this category.
- Organisation and administration of state PHP efforts: This category includes state services in support of a public health system: Collection of epidemiological data, processing and dissemination of information on addiction prevention (alcohol, tobacco, illegal substances, medication, and behavioural addictions) and for the prevention of non-communicable diseases (e.g. diabetes, asthma, cancer, cardiovascular disease, and mental disorders) and communicable diseases (e.g. flu, measles, HIV, borreliosis, and COVID-19), or market surveillance and information activities in the area of medical products.
- Other prevention: This category includes civil organisations providing a very wide range of services. These range from advice on respiratory diseases to prevention of falls and strengthening cross-cultural tobacco and alcohol prevention to promoting the social inclusion of persons with an invalidity insurance measure.
Definition
The indicator shows the percentage share of PHP expenditure in total health cost expenditure in Switzerland. It also shows PHP expenditure by service category.
The indicator is calculated on the basis of the Federal Statistical Office’s (FSO) “Health care costs and financing statistics”, analysing monetary flows in the area of “prevention”. The statistics present a synthesis of all available figures for an estimation of the monetary flows associated with the production, consumption and financing of goods and services of the Swiss health system during one year. The expenditure includes both material and personnel costs. The data are updated annually.
Service category titles:
- Addiction and NCD prevention: corresponds to the “primary prevention in addiction” category of the FSO’s “Health care costs and financing” statistics and to Function 431 “Alcohol and Drug Prevention” of the Federal Finance Administration’s financial statistics (FFA, HAM2 2017)
- Health care in schools: corresponds to the “Mental health, healthcare in schools” category from the FSO “Healthcare costs and financing” statistics and Function 433 “School health service” from the FFA finance statistics (HAM2 2017)
- Accident and injury prevention: is a category from the FSO “Health care costs and financing” statistics (annual reports)
- Food security: is a category from the FSO “Health care costs and financing” and corresponds to Function 434 “Food surveillance” from the FFA finance statistics (HAM2 2017)
- Organisation and administration of state PHP expenditure: corresponds to the “Awareness among population/target groups” category from the FSO “Health care and financing” statistics and corresponds to Function 432 “Disease control, other” from the FFA finance statistics (HAM2 2017)
- Other prevention: is a category from the FSO “Health care costs and financing” statistics (donor statistics, estimates, profit and loss accounts, and annual reports)
Switzerland’s 26 independent cantons finance their own prevention and health promotion. There is no uniformly applied definition as to what comes under prevention or health promotion. This makes it difficult to assign data in a uniform manner. For this reason, this indicator can only make an approximate estimate of PHP expenditure.
Source
- Federal Statistical Office (FSO) Costs and financing of the health care system (by service and funding scheme, in German and French)
References
- Organisation for economic co-operation and development (OECD): Health expenditure and financing (2019)
- Conference of Cantonal Directors of Finance (2017). Handbuch Harmonisiertes Rechnungsmodell für die Kantone und Gemeinden HRM2, Bern: Handbook HAM2.
Further information
- Gmeinder, M. et al. (2017): How much do OECD countries spend on prevention?, OECD Health Working Papers, No. 101, DOI: 10.1787/f19e803c-en: Study.
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