Better health services for the chronically ill

A growing number of elderly and chronically ill people need long-term treatment and care. This segment accounts for some 80 per cent of expenditure on health services. The Swiss National Science Foundation (SNSF) is launching National Research Programme “Smarter Health Care” (NRP 74) with the aim of improving the knowledge and data basis for providing care to the chronically ill, promoting innovative approaches and boosting health services research in Switzerland.

Promote knowledge transfer and strengthen research

“The aim of the NRP is to provide a basis for taking decisions about changes to health services,” explains Milo Puhan, President of the NRP 74 Steering Committee. “The results of this research will provide very specific benefits for the political community, service providers and patients.” In the past five years, health services research in Switzerland has been supported by a private foundation through a programme organised by the Swiss Academy of Medical Sciences (SAMS). From this year, NRP 74 will take over the funding of health services research in Switzerland and will promote the establishment of an internationally networked research community.

The right care for different needs

One of the major goals of NRP 74 is to reduce the over-provision of health services to patients. “Over-provision includes treatments that do not necessarily improve health or that can in fact be actually harmful to health,” Milo Puhan says. Examples are the administration of too many or unsuitable medicines or surgery that is not medically vital. NRP 74 is also focusing on the under-provision of health services to certain parts of the population. This is the case, for example, if a general medical practice in a rural area closes, making access to primary health care difficult.

Improve cooperation between healthcare professionals

The projects in NRP 74 will help to develop new models for treating and caring for chronically ill people. “Our system is still very doctor-centric, especially when it comes to the reimbursement of services,” explains Milo Puhan. However, doctors don’t always have to be involved in providing care for chronically ill patients. Other professionals are also important in providing good care.” Against this background, the NRP is studying the interfaces between in-patient and out-patient care and the care given to patients in their homes. It will also research collaboration between individuals in the different health care professions. NRP 74 will additionally help to improve the available body of data about health services, something that is necessary to ensure continuity of care if patients are transferred. “This is not currently happening because hospitals and doctors’ practices have their own systems and there are a number of registers and health databases that are not linked,” Milo Puhan explains.

The NRP in figures

NRP 74 has a budget of CHF 20 million. The NRP has so far approved 29 projects from a total of 173 proposals received. The project descriptions can now be found on the NRP website. Further calls for proposals are expected to follow. The projects will start from 2017 at ten research institutions throughout Switzerland (cantonal universities, universities of applied sciences and others). The first results of the research are expected in 2020. The synthesis report is scheduled for publication in 2022.

The Symposium on Health Services Research organised by the SAMS will take place in Bern on 1 March 2017.

NRP 74 website with an overview of the selected projects


Dr. Kathrin Peter
NRP 74 Programme Manager
Swiss National Science Foundation
Wildhainweg 3, CH-3001 Bern
Tel. +41 31 308 21 85

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