Since 2008 health promotion and preventive care expenditure by the cantons and communes in Switzerland has tended to decline: In 2008, expenditure on health promotion and preventive care was equal to 8% of curative care expenditure; by 2018, it was 5.2%. The relative share of expenditure on health promotion and preventive care during the period between 1998 and 2007 also shows a negative trend, falling from 14.8% (1998) to 11.3% (2007). Due to a break in the time series, care must be taken when making comparisons of the years 2007 and 2008.

This indicator is part of the Monitoring System Addiction and NCD (MonAM) of the Federal Office of Public Health (FOPH).

Assigned topics

Rising healthcare costs occupy a central place in discussions on Swiss healthcare policy. Non-communicable diseases such as cancer, diabetes or cardiovascular diseases are an important factor in rising costs. To a large extent these diseases are due to harmful behaviour, such as smoking, lack of exercise or excessive alcohol consumption etc. Good preventive care can help to reduce these risk factors.

This indicator shows cantonal and communal expenditure on health promotion and preventive care in relation to expenditure on «curative» care. In addition to finance from the cantons and communes, the Confederation itself funds prevention programmes directly.  Funding for health promotion and prevention also comes from a wide range of other stakeholders. The cantons and communes finance roughly a quarter of all preventive healthcare costs.

Various factors contribute to cuts in budgets for health promotion and preventive care when healthcare costs increase and the cantons and communes are under pressure to economise. As health promotion and preventive care are the responsibility of the cantons, there are no federal guidelines. In addition, it is inherently difficult to observe directly the impact of health promotion and preventive care measures. These are often implemented in a complex environment with numerous interactions between various influencing factors and agents. Furthermore, such measures are usually effective in the medium to long term.

Definition

This indicator was calculated on the basis of the Financial statistics and the Health care costs and financing statistics. It shows the ratio of the total cantonal and communal net expenditure on health promotion and preventive care to total cantonal and communal expenditure on «curative» care. This concerns the current account (current expenditure less current receipts) and the net government funding.

As the cantons differ in how they divide healthcare responsibilities between the canton and its communes, cantonal and communal expenditure are added together. The annual costs of healthcare can be taken from the  Financial statistics and the Healthcare costs and financing statistics (tables used: Funding with canton as direct payer and funding with commune as direct payer). These statistics take into account all available material on payments in order to estimate financial flows related to the production and consumption of goods and services in the Swiss healthcare system for a period of one year.

Curative services in this context include expenditure for hospitals, nursing homes, psychiatric clinics and outpatient care, as designated in the Federal Statistical Office’s data.

Based on Kaufmann (2015) the following categories from these statistics are shown in relation to one another:

  • Curative care: Hospital, Homes, Psychiatry, Outpatient
  • Preventive care and health promotion: Food surveillance, Disease control, Alcohol/addiction, Healthcare in schools, Healthcare system

For longer-term comparisons, please note that the categories changed between 2007 and 2008.

Sources

Reference

  • Kaufmann, M. (2015). Verhältnis zwischen Kuration und Prävention. Entwicklung der Nettoausgaben für Gesundheit in den Kantonen und Gemeinden zwischen 2002 und 2012. Soziale Sicherheit CHSS 6/2015, 363-366 (in German)

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Last updated

03/18/2021