Motivational interviewing for prevention in Swiss family medicine: Opportunities and challenges.

Health promotion and primary prevention are a priority in a healthcare system characterised by a prevalence of chronic conditions. In this context, motivational interviewing (MI) as provided by family doctors (FDs) seems promising: influential health professionals motivate patients to adopt healthy lifestyles in a patient-centred style that promotes a balanced, horizontal doctor-patient relationship. Based on these assumptions, a pilot project called Girasole was implemented in Switzerland between 2016 and 2018 to train and support 19 FDs in implementing MI in their practices.

Changes in private health service utilisation and access to the Italian National Health Service between 2006 and 2019: a cross-sectional comparative study.

Objectives: Previous research highlighted that in the early 2000s a significant share of the Italian population used and paid out of pocket for private healthcare services even when they could potentially have received the same treatments from the National Health Service (NHS). The decrease in public investments in healthcare and the increase in health needs due to the population ageing may have modified the use of private health services and equity of access to the Italian NHS. This study aims to investigate the change in the prevalence of individuals who have fully paid out of pocket for accessing healthcare services in Italy between 2006 and 2019 and the main reasons behind this choice.

Health economic evaluation of a nurse-led care model from the nursing home perspective focusing on residents' hospitalisations.

Background: Health economic evaluations of the implementation of evidence-based interventions (EBIs) into practice provide vital information but are rarely conducted. We evaluated the health economic impact associated with implementation and intervention of the INTERCARE model-an EBI to reduce hospitalisations of nursing home (NH) residents-compared to usual NH care.

Methods: The INTERCARE model was conducted in 11 NHs in Switzerland.

Positive effect of the INTERCARE nurse-led model on reducing nursing home transfers: A nonrandomized stepped-wedge design.

Background: Unplanned nursing home (NH) transfers are burdensome for residents and costly for health systems. Innovative nurse-led models of care focusing on improving in-house geriatric expertise are needed to decrease unplanned transfers. The aim was to test the clinical effectiveness of a comprehensive, contextually adapted geriatric nurse-led model of care (INTERCARE) in reducing unplanned transfers from NHs to hospitals.

Preventable hospitalizations from ambulatory care sensitive conditions in nursing homes: evidence from Switzerland.

Objectives: Reducing nursing home hospitalizations for ambulatory care sensitive conditions (ACSC) has been identified as an opportunity to improve patient well-being and reduce costs. The aim of this study was to identify number of hospitalizations for ACSCs for nursing home residents in a Swiss national sample, examine demographic characteristics of nursing home hospitalizations due to ACSCs, and calculate hospital expenses from these hospitalizations.

Methods: Using merged hospital administrative data with payment data based on diagnosis-related groups (DRGs) for the year 2013, we descriptively examined nursing home residents who were 65 years of age or older and were admitted to an acute care hospital.

Strengthening Geriatric Expertise in Swiss Nursing Homes: INTERCARE Implementation Study Protocol.

Objectives: Nursing home (NH) residents with complex care needs ask for attentive monitoring of changes and appropriate in-house decision making. However, access to geriatric expertise is often limited with a lack of geriatricians, general practitioners, and/or nurses with advanced clinical skills, leading to potentially avoidable hospitalizations. This situation calls for the development, implementation, and evaluation of innovative, contextually adapted nurse-led care models that support NHs in improving their quality of care and reducing hospitalizations by investing in effective clinical leadership, geriatric expertise, and care coordination.

Skill mix in Swiss primary care group practices - a nationwide online survey.

Background: Increasing chronic conditions and multimorbidity is placing growing service pressures on health care, especially primary care services. This comes at a time when GP workforce shortages are starting to be felt across Switzerland, placing a threat on the sustainability of good access to primary care. By establishing multiprofessional teams in primary care, service capacity is increased and the pressures on the GP workforce can be alleviated.

E-health in Switzerland: The laborious adoption of the federal law on electronic health records (EHR) and health information exchange (HIE) networks.

Within the framework of a broader e-health strategy launched a decade ago, in 2015 Switzerland passed a new federal law on patients' electronic health records (EHR). The reform requires hospitals to adopt interoperable EHRs to facilitate data sharing and cooperation among healthcare providers, ultimately contributing to improvements in quality of care and efficiency in the health system. Adoption is voluntary for ambulatories and private practices, that may however be pushed towards EHRs by patients.

Switzerland: Health System Review.

This analysis of the Swiss health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The Swiss health system is highly complex, combining aspects of managed competition and corporatism (the integration of interest groups in the policy process) in a decentralized regulatory framework shaped by the influences of direct democracy. The health system performs very well with regard to a broad range of indicators.

Swiss popular initiative for a single health insurer… once again!

The article describes a recent Swiss popular initiative, aiming to replace the current system of statutory health insurance run by 61 competing private insurers with a new system run by a single public insurer. Despite the rejection of the initiative by 62% of voters in late September 2014, the campaign and ballot results are interesting because they show the importance of (effective) public communication in shaping the outcome of a popular ballot. The relevance of the Swiss case goes beyond the peculiarities of its federalism and direct democracy and might be useful for other countries debating the pros and cons of national unitary health insurance systems versus models using multiple insurers.

Italian public health care organizations: specialization, institutional deintegration, and public networks relationships.

The Italian National Health Service (INHS) has undergone profound changes over the past three decades. With establishment of the INHS in 1978--a tax-based public health care system with universal coverage--one of the underlying principles was integration. The recognition of health and health care as requiring integrated answers led to the creation of a single public organization, the Local Health Unit, responsible for the health status of the population of its catchment area.

[Nurses and nephrology in Italy].

An acceleration in the professionalization of Italian nurses has taken place in recent years. This pattern, together with the increasing prevalence of kidney diseases and the decreasing number of active nephrologists, makes a new collaborative structure between nurses and nephrologists both possible and welcome. This article describes the recent changes and future prospects of the Italian nursing profession.

[The demographic profile of Italian nephrologists].

For many years Italy has had more active physicians than most Western countries. However, the numerus clausus introduced in 1986 for entry into medical schools together with a sharp decrease in places available in specialty training have changed the situation dramatically and today several specialties suffer actual shortages. In such a situation, professional demography is crucial to outline possible developments for the medical profession and nephrology in particular.

Ability to pay and equity in access to Italian and British National Health Services.

Background: Equity in delivery and distribution of health care is an important determinant of health and a cornerstone in the long way to social justice. We performed a comparative analysis of the prevalence of Italian and British residents who have fully paid out-of-pocket for health services which they could have obtained free of charge or at a lower cost from their respective National Health Services.

Methods: Cross-sectional study based on a standardized questionnaire survey carried out in autumn 2006 among two representative samples (n = 1000) of the general population aged 20-74 years in each of the two countries.

Private medical services in the Italian public hospitals: the case for improving HRM.

This study explores how Italian public hospitals can use private medical activities run by their employed physicians as a human resources management (HRM) tool. It is based on field research in two acute-care hospitals and a review of Italian literature and laws. The Italian National Health Service (NHS) allows employed physicians to run private, patient-funded activities ("private beds", surgical operations, hospital outpatient clinics, etc.

Converging patterns in hospital organization: beyond the professional bureaucracy.

This study builds a framework to investigate the current trends emerging in hospital organizational design and its main consequences on human resources management. The analysis derives from an extensive literature review, which shows over the last 30 years a significant lack of works on organization design for hospitals, and from a number of experiences in hospital settings, which provide useful insights on changes taking place in hospitals. We intend to contribute to the filling of the gap in literature created by the lack of interest scholars have shown on hospital organization.