School of Medicine, University of St.Gallen, St.Jakob-Strasse 21, 9000 St, Gallen, Switzerland.
Technische Universität Berlin, Straße des 17. Juni 135, Berlin 10623, Germany; Spital Männedorf AG/Zürich, Asylstrasse 10, 8707, Männedorf, Switzerland.
Health Policy. 2022 Dec;126(12):1277-1282. doi: 10.1016/j.healthpol.2022.09.011. Epub 2022 Sep 25.
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 fulfill 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.
大多数发达国家在医院容量和住院服务上花费了大量的卫生预算。然而，这些容量和服务往往没有得到全面规划，导致服务提供方向不明确，医院设施也不是按需驱动的。瑞士则不同，其规划程序在 2012 年进行了彻底改革，并在 2021/2022 年进一步完善。瑞士的苏黎世州是先行者，对其急性、精神科和康复护理的医院容量规划模型进行了全面更新。该模型的结果是医院名单。该名单包括所有符合预先定义的质量、效率和需求要求的医院。名单上的医院获得了为特定和选定服务群体（n=196）提供住院治疗的授权，这些群体聚类为三个领域（急性护理、精神病学、康复）。基础医疗保健政策过程是透明的，所有相关行为者都高度参与。规划模型的构建模块是服务群体的分类系统、附加到这些群体的不同质量和效率要求，以及对当前和未来医疗保健需求的分析。愿意提供服务的医院必须申请并证明符合要求。然后，州政府根据需求决定哪家医院可以提供哪些服务。
