Primary care in Switzerland: evolution of physicians' profile and activities in twenty years (1993-2012).

Détails

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Etat: Public
Version: Final published version
ID Serval
serval:BIB_2507D3DC5813
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Primary care in Switzerland: evolution of physicians' profile and activities in twenty years (1993-2012).
Périodique
Bmc Family Practice
Auteur(s)
Cohidon C., Cornuz J., Senn N.
ISSN
1471-2296 (Electronic)
ISSN-L
1471-2296
Statut éditorial
Publié
Date de publication
2015
Peer-reviewed
Oui
Volume
16
Numéro
1
Pages
107
Langue
anglais
Notes
Publication types: Historical Article ; Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: epublish
Résumé
BACKGROUND: According 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.
METHODS: The 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.
RESULTS: In 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).
CONCLUSION: This 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.
Mots-clé
Age Factors, Cross-Sectional Studies, Female, History, 20th Century, History, 21st Century, Humans, Male, Middle Aged, Physicians, Primary Care/history, Physicians, Primary Care/statistics & numerical data, Practice Patterns, Physicians'/history, Practice Patterns, Physicians'/statistics & numerical data, Primary Health Care/history, Primary Health Care/statistics & numerical data, Sex Factors, Surveys and Questionnaires, Switzerland
Pubmed
Web of science
Open Access
Oui
Création de la notice
15/09/2015 16:34
Dernière modification de la notice
20/08/2019 13:03
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