Figure 1
A population-oriented health system in the Swiss Alps.
Figure 2
CSEB’s organisation as of January 2018.
Table 1
Demographic aging and rising demand for inpatient and ambulatory care.
| 2005 | 2010 | 2015 | 2020 | 2025 | 2030 | |
|---|---|---|---|---|---|---|
| Population | 7,600 | 7,650 | 7,700 | 7,750 | 7,800 | 7,800 |
| Population aged 80 + | 403 | 434 | 457 | 483 | 506 | 530 |
| In % of total population | 5.3% | 5.7% | 5.9% | 6.2% | 6.5% | 6.8% |
| Demand for long-term inpatient care among 80 + in % | 26.1% | 26.3% | 26.5% | 26.7% | 26.9% | 27.0% |
| Demand for long-term inpatient care (number of clients) | 105 | 114 | 121 | 129 | 136 | 143 |
| Available spaces (as of 2007) | 94 | 95 | 95 | 95 | 95 | 95 |
| Long-term inpatient care shortage (as of 2007) | –11 | –19 | –26 | –34 | –41 | –48 |
| Demand for ambulatory care among 80 + in % | 24.8% | 25.0% | 25.2% | 25.4% | 25.6% | 25.7% |
| Demand for ambulatory care (number of clients) | 100 | 109 | 115 | 123 | 130 | 136 |
Table 2
Key services and segments of the Lower Engadin’s population health system.
| Services | Population segment | Service offerings (in italics: new services added since CSEB’s foundation in 2007) | Network members |
|---|---|---|---|
| Health promotion and prevention | Children and adolescents | Advice on movement and nutrition, organisation of leisure time and addiction prevention for adolescents. | Schools, sports clubs |
| Middle-aged adults | Health promotion and prevention in the middle years and at the work place: Coping with stress, dealing with new media. | Businesses | |
| Elderly people | Future workshops, preventive home visits, health checks, housing counselling. | Social services | |
| Ambulatory primary care | Whole target population | Mobile rescue service in three locations. Ambulatory emergency care in regional hospital. | |
| Ambulatory specialised care | Medical consultancy in ophthalmology, dermatology, gastroenterology, neuropediatrics, oncology, otolaryngology, paediatrics, psychiatry, radiology, and wound management. | Private medical consultants | |
| Inpatient primary care | Whole target population | Surgery (traumatology, orthopaedics, visceral surgery, manual medicine); internal medicine (cardiology, angiology, pulmonology, sports medicine, palliative care); obstetrics and gynaecology; anaesthesia (pain therapy, transfusion medicine, emergency medicine); complementary medicine. | |
| Rehabilitation | Whole target population | Inpatient oncological, internal and psycho-somatic rehabilitation in regional hospital and hotels. Ambulatory physiotherapy and physical medicine in the thermal spa. | Hotels, private medical consultants |
| Ambulatory home care and inpatient long-term care | Elderly people | Ambulatory home care: Help and care in crisis situations, support and relief of caring relatives, post-acute health and nursing services, housekeeping and meal services. | |
| Inpatient long-term care in the regional hospital and three decentralised care groups in collaboration with a regional nursing home. | Private nursing home | ||
| Dementia care in long-term facilities. | Dementia association | ||
| Case management | Elderly people | Central contact point for all questions related to aging and care in the region. Advice for patients and their relatives with complex care needs. | Dementia association, social welfare, private GPs, private volunteers |
| Referral of temporary inpatient care services; implementing health promotion and prevention programs; maintaining a pool of regional volunteers for providing ambulatory care and social services. | |||
| Health tourism | Tourists | In collaboration with the regional tourism industry, CSEB offers a range of health tourism products in order to add positive contribution margins to its operations. The offering includes health promotion and prevention (e.g. health checks in the regional hospital, workshops and seminars); gluten- and lactose-free holidays in collaboration with regional hotels, restaurants and businesses; temporary inpatient care for holiday guests with care needs; wheelchair accessible holidays; and lectures and regional health experiences. | Accomodation providers, restaurants, businesses, private medical consultants |
| Integrated shared services | n/a | CSEB and the thermal spa pool their shared services including IT, marketing, finance, HR, and logistics to increase the efficiency and quality of these services. |
Figure 3
CSEB’s operating profits 2008–2016 (Source: CSEB Controlling).
Figure 4
Healthcare costs per insured person (data are standardised according to sex and age). Healthcare costs include ambulatory and inpatient costs for care and the hospital as well as physical therapy, reflecting CSEB’s services (Source: Swiss Health Observatory, Health Department Canton Grisons).
Figure 5
Patient satisfaction with CSEB’s services (Source: CSEB Controlling).