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

Authors:
Chantal Mamie at Hôpitaux Universitaires de Genève
Chantal Mamie
Francois Clergue
Francois Clergue
Francois Clergue
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Davide Zoccatelli at Hôpitaux Universitaires de Genève
Davide Zoccatelli
Guy Haller at Hôpitaux Universitaires de Genève
Guy Haller
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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. 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. 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. 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.
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[French residents in anaesthesia and critical care - a nationwide survey].
Article
  • Sep 2004
  • ANN FR ANESTH
We surveyed the residents in their first (R1) and fourth (R4, last) years of residency in anaesthesia and intensive care in France. The questionnaires mailed to each resident were designed to obtain personal data, motivation for specializing in anaesthesia and their opinion of their training. The response rates were 48% for the R1 residents and 77% for the R4 residents. There were 40% females in this population and the R1 residents were 25 +/- 1 year old, 29 +/- 2 year-old for the R4 residents. Almost half (46%) of the R1 responders were married as were 74% of the R4 residents. They spent an average of 726 each year on books, computers and other educational items. Most (71%) had opted for anaesthesia after considering other medical specialties, but only 12% had considered surgery. Half (51%) were on a training program that was far away from their home. They thought highly of their training, with the clinical training being rated above the non-clinical component. About half of them had obtained specialized certificates (mainly additional certification in intensive care and antibiotic therapy) during their residency. Two thirds of those in R4 expected to work in a public hospital and about one third expected to work in intensive care. Money was an important factor in their choice of profession. A majority planned to remain in the area where they had graduated in anaesthesia after their residency. Finally, 96% declared that they would choose anaesthesia again if they had to do so. French residents in anaesthesia are satisfied of their initial choice for anaesthesia and don't regret it at the end of their residency training.
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