Spitex: The most important facts about external home help and care

However, for many relatives, providing care at home is not something they can manage alone, so they seek professional help. Spitex offers care for people in need of care in their familiar surroundings by qualified nursing staff.

Which Spitex organizations exist

In Switzerland, there are two types of Spitex organizations: non-profit organizations and profit organizations.

Non-profit organizations are non-profit Spitex organizations that operate at a communal level. The profit organizations, on the other hand, are private profit-oriented organizations with a commercial focus.

There are also some independent care professionals, but they only account for a small share of the market.

The history of Spitex

The first community nursing service was established in Zurich as early as 1857, and other communities followed suit. A few years later, in 1882, the first home care organization was founded with the aim of supporting families whose mothers were unable to run the household due to childbirth or other illnesses. At this time, the nurses still worked for a very small fee or even for free.

It was not until the beginning of the 20th century that the city of Zurich provided funding to continue home and community nursing.

In 1947, the Spitex central office was founded to implement improvements in the employment and training of nursing staff.

Facts, figures and data

The number of people employed in the Spitex sector has been rising steadily since 2002. In 2017 alone, there were already more than 2,000 service providers with around 22,660 full-time equivalent employees who provided care and housekeeping support to around 350,000 people in Switzerland.

Around 80% of the services were provided by non-profit Spitex organizations. People in the 80+ age group have the greatest need for Spitex services, with around 10% more care services being used than domestic services.

What services do people in need of care receive from Spitex

If people in need of care are cared for by qualified nursing staff in their home environment, employees of a Spitex organization are usually commissioned.

The standard services for the care and support of patients in their home environment are set out in Art. 7 para. 2 of the Nursing Care Services Ordinance and include

Assessment of care needs and advice on services

Together with Spitex, the current need for care is individually clarified and presented to the attending physician. Spitex's services also include comprehensive advice for the patient and family carers on important topics such as fall prevention.

Basic care

The patient is supported with personal hygiene and receives help with getting up and getting dressed. The carer also offers assistance with eating meals and other activities of daily living.

Nursing and treatment care

Nursing and treatment care services include wound care and dressing changes, preparing and administering medication, incontinence care, injections and infusions, medical checks such as blood pressure, blood sugar and pulse measurements, blood sampling and pain treatment.

Care after a stay in hospital

Acute and transitional care is provided for a maximum period of two weeks after a hospital stay and includes follow-up care in the home environment.

Palliative care

In palliative care, seriously ill and dying patients are cared for with medical and nursing measures to alleviate their symptoms and ensure the best possible quality of life for as long as possible.

Psychiatric care

Psychiatric care helps people with mental illnesses to cope with basic everyday situations.

Domestic help

This mainly includes preparing meals and cleaning the home.

In some regions of Switzerland, Spitex also offers services such as transportation to the doctor, help with daily shopping and meal services. Various aids such as crutches or wheelchairs can also be rented from some Spitex organizations.

Which services are covered by health insurance

The health insurance company covers the basic care of the patient and pays for care services according to the Spitex prescription of the attending physician.

ATTENTION: 10% of the care costs must be paid by the insured person as a deductible, but this is limited to a maximum of CHF 15.95 per day, depending on the canton.

Any housekeeping assistance required is not covered by the health insurance and must be paid for by the patient. Some health insurance companies offer supplementary insurance that covers the costs of domestic assistance. Some municipalities support people in need of care and bear part of the costs for home help.

How do people in need of care access Spitex services?

If care is required, a Spitex organization is commissioned to provide care. This organization determines the actual need for care services by means of a needs assessment.

A written prescription is then obtained from the attending doctor based on the needs assessment. The declaration of need and the doctor's prescription must be submitted to the health insurance company within three weeks in order to ensure timely reimbursement of the costs already incurred.

If more than 60 hours of care are required per quarter, a separate application must be submitted to the health insurance fund.

In order to ensure ongoing and needs-based care, a regular needs assessment is required by law.

What does the future of Spitex look like and what do customers want?

According to the "Take Care" study by Senesuisse, the association of retirement and care facilities, demographic change is taking place, people are getting older and more qualified care professionals are needed.

People in need of care want to be cared for by the same person over a longer period of time, which is also a question of trust. However, patients' needs and wishes are also becoming increasingly individualized and a flexible care system is required.

There is still a shortage of skilled staff, and although advancing digitalization and the use of care robots cannot solve this problem, the use of IT-supported systems can improve processes.