How is the need for care determined?
In order to determine what care needs exist in specific situations, a needs assessment is essential. This is handled differently in Switzerland's 26 cantons, as the cantons are free to introduce their own needs assessment systems (Federal Supreme Court ruling of 7 October 2019). Private Spitex providers in all cantons are happy to help patients clarify their needs for outpatient care services. They are reimbursed by the health insurance companies for the professional advice they provide, so that no costs are incurred by the patient. You can find out more about the needs assessment process here, for example. Take the opportunity to find out more!
In general, care services in Switzerland are provided by the
- Health Insurance Act (KVG) and
- the Health Care Benefits Ordinance (KLV).
- Clarification, advice and coordination
- Examination, treatment
- basic care
Outpatient care costs with Spitex
With Spitex, a specialist determines the care requirement based on the actual time required .
Various care needs assessment systems exist in order to correctly classify those in need of care.
If you commission a private Spitex provider to assess your needs, they will usually determine your care requirements using RAI-Home Care Switzerland. RAI-HC is an assessment tool for adults, usually older people, who are cared for and looked after at home by Spitex .
Assessingneedswith this tool guarantees a high quality of care, individually tailored to the needs of the patient. The focus here is onthe greatest possible independence and a high quality of life.
This is what the health insurance company pays for outpatientcare costs (as at 01.02.2021) and this is how high the deductible is for patients:
| Services | Contributions from insurers per hour | Contributions from the patient in the canton of Zurich per day | Contributions from the patient in the canton of Aargau per day |
| Basic care (eating and drinking, washing, dressing, mobilizing, etc.) | CHF 52.60 | CHF 7.65 | CHF 15.35 |
| Examination and treatment (medication administration, wound care, blood pressure measurement, etc.) | CHF 63.00 | CHF 7.65 | CHF 15.35 |
| Assessment and consultation (care planning, guidance on medication intake, etc.) | CHF 76.90 | CHF 7.65 | CHF 15.35 |
In the case of Spitex, the cost sharing of the health insurance companies is based on the actual care time. The care costs are shared between the health insurance company, the patient and the public purse. The prerequisite for this is a doctor's prescription, which is determined with the needs assessment. It applies to all care services .
Important:the need for care is not the same as the need for assistance
The need for care includes all measures and assistance that a person requires from others to carry out daily tasks due to illness or disability in order to ensure high-quality healthcare.
Non-nursing services, e.g. washing, cooking, accompaniment to medical appointments,etc. must be provided by the patient.
We will be happy to advise you in detail on the subject of care requirementsand care costs. Take advantage of our non-binding, free initial consultation.
