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. 2019 Mar 4;20(1):39.
doi: 10.1186/s12875-019-0926-7.

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

Renata Josi  1 , Carlo De Pietro  2
Affiliations

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

Renata Josi et al. BMC Fam Pract. .

Abstract

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. The roles of non-medical health professions in primary care are not established so far in Switzerland and the personnel composition of primary care group practices is not known. Therefore this study aims to provide insights into the current composition, educational background and autonomy of the these new professional roles in primary care.

Methods: For this descriptive exploratory study a web-based online survey methodology was used. Group practices were defined as being a medical practice with any specialisation where at least three physicians work together in a team. Based on this restriction 240 eligible group practices were identified in Switzerland. The following four tertiary-level health professions were included in the study: nurses, physiotherapists, occupational therapists and dietitians. Additionally medical practice assistants with couselling competencies were included.

Results: A total of 102 practices answered the questionnaire which is equivalent to an answer rate of 43%. The sample included data from 17 cantons. 46.1% of the practices employed non-physician health professionals. Among the tertiary-level health professions, physiotherapists were the most frequent profession with a total of 78 physiotherapists over all group practices, followed by nurses (43), dietitians (34) and occupational therapists (3). In practices which employ those professionals their average number per practice was 3.4. 25.5% of the practices had health professionals employed with advanced roles and competencies.

Conclusion: The results from this study demonstrate that while nearly 50% of groups practices have established non-physician professionals, only 25% of practices integrate these professionals with advanced roles. Compared with other countries, there would appear to be significant scope to extent and broaden the uptake of non-physician professionals in primary care in Switzerland. Clear policy direction along with supporting regulation and financing arrangements are required.

Keywords: Advanced roles; Personnel composition; Primary care.

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Conflict of interest statement

Ethics approval and consent to participate

According to the Swiss Human Research Act [40] this study type in Switzerland does not require ethical approval from a cantonal ethics committee. Formal informed consent was therefore not necessary but all participants were informed either via telephone by the first author or with a short information text about the aim and content of the survey. Participants consented verbally at the telephone or via email if they wanted to participate in the study. Participation was at any point voluntary.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Correlation of the number of doctors and medical practice assistants
Fig. 2
Fig. 2
Distribution of the total number of health professionals (nurses, physiotherapists, dietitians or occupational therapists) per group practice
Fig. 3
Fig. 3
Correlation of the number of doctors and health professionals
See this image and copyright information in PMC

References

    1. Beard JR, Officer A, de Carvalho IA, Sadana R, Pot AM, Michel J-P, Lloyd-Sherlock P, Epping-Jordan JE, Peeters GMEEG, Mahanani WR, Thiyagarajan JA, Chatterji S. The world report on ageing and health: a policy framework for healthy ageing. Lancet. 2016. 10.1016/S0140-6736(15)00516-4. - PMC - PubMed
    1. Prince MJ, Wu F, Guo Y, Gutierrez Robledo LM, O’Donnell M, Sullivan R, Yusuf S. The burden of disease in older people and implications for health policy and practice. Lancet. 2015. 10.1016/S0140-6736(14)61347-7. - PubMed
    1. Staatssekretariat für Bildung, Forschung und Innovation. Gesamtsicht Aus- und Weiterbildung Medizin Im System der Gesundheitsversorgung. 2016. https://www.sbfi.admin.ch/dam/sbfi/de/dokumente/2016/02/gesamtsicht_aus-.... Accessed 18 Jun 2018.
    1. Schweizerische Konferenz der kantonalen Gesundheitsdirektorinnen und -direktoren Odasanté. Nationaler Versorgungsbericht Für die Gesundheitsberufe. 2016. https://www.gdk-cds.ch/fileadmin/docs/public/gdk/themen/gesundheitsberuf.... Accessed 18 Jun 2018.
    1. Cohidon C, Cornuz J, Senn N. Primary care in Switzerland: evolution of physicians’ profile and activities in twenty years (1993–2012). BMC Fam Pract. 2015. 10.1186/s12875-015-0321-y. - PMC - PubMed

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