Primary care in Switzerland: evolution of physicians’ profile and activities in twenty years (1993–2012)

Abstract

BackgroundAccording to the Organization for Economic Cooperation and Development, the Swiss healthcare system is one of the most effective in the world. Yet, as other occidental countries, it has to face the increase of chronic diseases frequency and its resulting cost, particularly for primary care (PC). However very few consistent data are available to describe PC features and its evolution over time. The aim of this study is to describe the evolution of the Swiss PC physicians’ (PCPs) profile and activities between 1993 and 2012.MethodsThe date come from two independent European surveys carried out in Switzerland respectively in 1993 and 2012. Both surveys were cross-sectional ones and based on representative samples of 200 PCPs, interviewed by questionnaire.ResultsIn 20 years, PCPs became older (median age 46 vs 56, p < 0.001) and more feminized (7 % vs 22 %, p < 0.001). Nowadays, they more often work in group practices (28 % vs 52 % in 2012, p < 0.001) and are more involved in other paid activities (28 % vs 66 % in 2012, p < 0.001). All the PCPs have a computer in 2012 (78 % in 1993, p < 0.001) and it is mostly used for keeping records of consultations (47 %). The number of daily face-to-face contacts with patients decreased from 31 to 24 but the average length rose from 15 to 20 min (p < 0.001). PCPs provide fewer pediatric and gynecological services but their activity remains globally unchanged in other domains. The frequency of meetings with other disciplines decreased significantly (e.g. once/month face-to-face meets with ambulatory specialists: 78 % vs 23 % in 2012, p < 0.001). The involvement of PCPs in follow-up and treatment of chronic disease globally little differed. In 2012, 8.5 % of the PCPs never performed any chirurgical acts (vs 0 % in 1993, p < 0.001).ConclusionThis study showed a substantial evolution of Swiss PC over the last twenty years in terms of socio-demographic, organizational and service provided. The main changes include: feminization and ageing, lower diversity in services provided, fewer but longer consultations. These changes may have important implications for patients’ management and will need to be considered for health planning purposes.

Rates, Delays, and Completeness of General Practitioners’ Responses to a Postal Versus Web-Based Survey: A Randomized Trial

“…For Switzerland, the postal sample appeared to be slightly more representative of all community-based GPs (median age of 56 years and 78% men in 2015 [25]) regarding the median age (median 53.7, IQR 45.7-60.9, for the postal group, and 45.9, IQR 42.9-60.9, for the Web-based group) and gender distribution (men: 215/353, 60.9%, for the postal group and 25/53, 47%, for the Web-based group).…”

Differences in medical services in Nordic general practice: a comparative survey from the QUALICOPC study

“…A study from 2001 explored differences in consultation rates and diagnoses given by Nordic GPs [8]. Some more recent studies from other European countries describe the spectrum of medical equipment in the respective countries [9,10]. It remains unknown how this compares to the situation in the Nordic countries.…”

Swiss family physicians’ perceptions and attitudes towards knowledge translation practices

“…In an environment in which possible sources of information constantly accumulate, it is crucial to understand and identify the major sources of scientific information that are used by physicians to keep their medical knowledge up to date, and how they concretely take in and use these sources. We focused on family physicians because they need to update their knowledge in many different fields and have to cooperate with other medical specialists [ 13 ]. The complex profile of family physicians makes it even more difficult to know how they integrate new scientific knowledge into their daily practice, how they combine various information sources, and how they adapt this information to patients presenting with different health conditions [ 2 ].…”