Dominik Moser

Aim of study: The aim of the study was to investigate whether there are regional differences in the treatment results of elective mammary resections for breast cancer in Switzerland and, if so, whether a possible cause could be found in the hospital planning by the cantons. Methods; Using the Inpatient Quality Indicators (CH-IQI), the quality of outcomes was analysed at the level of the Swiss cantons and compared with the cantonal requirements for carrying out this treatment. Results: Cantonal differences became apparent both in the quality of results based on the quality indicator of breast preservation and in the level of detail of the requirements for structural and process quality. Conclusion: The quality of treatment in Switzerland can hardly be compared in a transparent manner; interpreting the available quality information is demanding and hardly possible for patients. In order to reduce the quality differences shown, hospital planning should be intercantonal, as is the case in highly specialised medicine.

Quality transparency is a crucial basis for reducing information asymmetries in the health care system. But what information on inpatient, acute-somatic care is available in Switzerland, how can it be used and what are the consequences? To answer these questions, a review of the data available is undertaken, systematically processed and strengths and weaknesses identified. On this basis, as well as international comparisons, health policy recommendations for an improvement of the current conditions follow. The study shows that quality transparency in Switzerland is limited, despite the national quality contract agreed in 2011. This makes it difficult to strengthen quality competition, to make informed decisions about patients’ choice of hospital and to contract selectively. Further development of the data and measurement instruments available in hospitals in Switzerland is therefore indicated and requires prioritised implementation.