Schoenenberger Andreas W, Stuck Andreas E
University Department of Geriatrics, Spital Bern-Ziegler, Morillonstrasse 75-91, CH-3001 Berne, Switzerland.
J Am Geriatr Soc. 2006 Jun;54(6):986-90. doi: 10.1111/j.1532-5415.2006.00746.x.
Switzerland has the second-most-expensive healthcare system worldwide, with 11.5% of gross domestic product spent on health care in 2003. Switzerland has a healthcare system with universal insurance coverage and a social insurance system, ensuring an adequate financial situation for 96% of the 1.1 million older inhabitants. Key concerns related to the care of older persons are topics such as increasing healthcare costs, growing public awareness of patient autonomy, and challenges related to assisted suicide. In 2004, the Swiss Academy of Medical Sciences issued guidelines for the care of disabled older persons. Since 2000, geriatrics has been a board-certified discipline with a 3-year training program in addition to 5 years of training in internal or family medicine. There are approximately 125 certified geriatricians in Switzerland, working primarily in geriatric centers in urban areas. Switzerland has an excellent research environment, ranking second of all countries worldwide in life sciences research-but only 13th in aging research. This is in part due to a lack of specific training programs promoting research on aging and inadequate funding. In addition, there is a shortage of academic geriatricians in Switzerland, in part due to the fact that two of five Swiss universities had no academic geriatric departments in 2005. With more-adequate financial resources for academic geriatrics, Switzerland would have the opportunity to contribute more to aging research internationally and to improved care for older patients.
瑞士拥有全球第二昂贵的医疗保健系统，2003年其医疗保健支出占国内生产总值的11.5%。瑞士拥有一个全民医疗保险覆盖的医疗保健系统和一个社会保险系统，确保了110万老年居民中96%的人有足够的经济状况。与老年人护理相关的关键问题包括医疗保健成本增加、公众对患者自主权的认识不断提高以及与协助自杀相关的挑战等话题。2004年，瑞士医学科学院发布了照顾残疾老年人的指南。自2000年以来，老年医学成为一门有董事会认证的学科，除了需要在内科或家庭医学领域接受5年培训外，还需进行为期3年的培训项目。瑞士大约有125名获得认证的老年医学专家，主要在城市地区的老年医学中心工作。瑞士拥有出色的研究环境，在生命科学研究方面在全球所有国家中排名第二，但在衰老研究方面仅排名第13。这部分是由于缺乏促进衰老研究的特定培训项目以及资金不足。此外，瑞士学术老年医学专家短缺，部分原因是2005年瑞士五所大学中有两所没有学术老年医学系。如果为学术老年医学提供更充足的财政资源，瑞士将有机会在国际上为衰老研究做出更多贡献，并改善对老年患者的护理。
