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Original article

Vol. 141 No. 3940 (2011)

Swiss healthcare cost containment policies and their impact on anaesthetists’ density and satisfaction

  • C Mamie
  • F Clergue
  • D Zocatelli
Cite this as:
Swiss Med Wkly. 2011;141:w13251


INTRODUCTION: To control healthcare costs, Federal and Cantonal states have introduced policies to limit expenses and the number of practising physicians. It is unclear to date whether these policies have had a real impact on anaesthetists in Switzerland. The aim of the current study was to assess the density, characteristics and satisfaction of anaesthetists in Latin Switzerland and to compare the results with data collected before the introduction of cost containment policies in 2002.

METHOD: We performed a cross-sectional study between March and July 2009 and included all practicing anaesthetists in Latin Switzerland. A questionnaire consisting of 103 items analysing demographics, activity and job satisfaction was used. The results were analysed and compared to a previous survey conducted in 2002.

RESULTS: Compared to 2002, there was an overall 12% increase in the number of practising anaesthetists who were older and more often females (42% versus 35% in 2002 (p = 0.06)). The number of non-Swiss anaesthetists significantly increased to 19% compared to 11% in 2002 (p <0.05). In contrast, working hours in public hospitals decreased from 59 to 53 hours/week (p <0.001). The majority of anaesthetists considered that their overall personal situation was better than in the previous 10 years and 87.7% considered that these measures had no impact on their future plans.

CONCLUSIONS: Implicit rationing policies introduced in Switzerland to limit healthcare costs and the number of physicians has had no impact on anaesthetists’ workforce density, working conditions and overall satisfaction in Latin Switzerland. This opens the question of the real usefulness of these policies, at least for anaesthetists.


  1. Office Fédéral de la Statistique. Annuaire statistique de la Suisse 2004, Zürich: Neue Zürcher Verlag, 2004.
  2. OFS, «Coûts du système de santé et démographie: Coûts détaillés par âge en 2002 et évolution sur la période 1985–2020», Rapport technique, Neuchâtel: Office fédéral de la statistique, 2005a.
  3. Organisation for Economic Co-Operation and Development. OECD Health Data 2010. Available at Accessed November 5 2010.
  4. Santos-Eggimann B. Is there evidence of implicit rationing in the Swiss Healthcare system. Final report to the Swiss Federal Office of Public Health / OFAS Ko/02 VW 625.
  5. Petit-Pierre M-C-. La question du rationnement des soins devient toujours plus pertinente. Le Temps 1998;17 dec:12.
  6. Brunner HH. Structure tarifaire uniforme: Compte rendu sur le projet GRAT INFRA I. Bulletin des médecins suisses 1999;80(5):243–6.
  7. OFS, «Statistique des hôpitaux 1997–2000»: Evolution du nombre de lits, du nombre de cas et de la durée moyenne de séjour sur la base de la statistique des hôpitaux de l’OFS. Rapport technique, Neuchâtel: Office fédéral de la statistique, 2003a.
  8. OFS, «Coût de la santé en Suisse»: Evolution de 1960 à 2000. Rapport technique, Neuchâtel: Office fédéral de la statistique, 2003a.
  9. Législation fédérale. Ordonnance RS 832.103 Ordonnance sur la limitation de l’admission des fournisseurs de prestations à pratiquer à la charge de l’assurance-maladie obligatoire. Available at Accessed 20 December 2010.
  10. Hänsgen K-D, Spicher B. Numerus Clausus: le «test d’aptitudes pour les études de médecine» (AMS) permet-il de trouver les personnes les plus aptes? Bulletin des médecins suisses; 2002.
  11. Dorsey ER, Jarjoura D, Rutecki GW. Influence of controllable lifestyle on recent trends in specialty choice by US medical students. JAMA. 2003;290(9):1173–8.
  12. Gautier JF, N’Guyen JL, Soltner C, Beydon L. French residents in anaesthesia and critical care – a nationwide survey. Ann Fr Anesth Reanim. 2004;23(8):794–8.
  13. Egger Halbeis CB, Cvachovec K, Scherpereel P, Mellin-Olsen J, Drobnik L, Sondore A. Anaesthesia workforce in Europe. Eur J Anaesthesiol. 2007;24:991–1007.
  14. Mamie C, Meyer P-A, Crettenand B, Morabia A, Clergue F. Evolution prévisible des effectifs médico-infirmiers en anesthésie en Suisse romande. Revue Médicale Suisse. 2004;491:1–9.
  15. Thomas CB. Observations on some possible precursors of essential hypertension and coronary artery disease. Bull Johns Hopkins Hosp. 1951;89:419–41.
  16. Deom M, Agoritsas T, Bovier PA, Perneger TV. What doctors think about the impact of managed care tools on quality of care, costs, autonomy, and relations with patients. BMC Health Serv Res. 2010;7;10:331.
  17. Simoens S, Hurst J. OECD Publishing Services.The Supply of Physician Services in OECD Countries. OECD Health Working Papers 2006: 21.
  18. Paris V, Devaux M, Wei L. OECD Publishing Services. Health Systems Institutional Characteristics: A Survey of 29 OECD Countries. OECD Health Working Papers 2010: 50.
  19. Conseil Suisse de la Science et de la Technologie. Démographie médicale et réforme de la formation professionnelle des médecins; 2007.