Swiss hospital food : optimisation potential

Abstract

Aim: In 2012 Switzerland will reimburse hospital costs through the diagnosis related group system (DRG), a system known for many years all around the world. This is a fundamental change as up to 2011 hospitals were paid for their cost, whatever they priced (Fetter, 1991; Teisberg, 2008). One of the aims of the Swiss government is to handle the on-going raise of health care cost and hospitals have to budget with the prospective reimbursement schema. Therefore hospitals need to analyse their processes in terms of effectiveness and efficiency. Intention of our research was to detect how this change influences hospitals meal provisions for patients, in order to identify possible efficiency potential. Methods: Literature review and qualitative interviews Findings: Today's spending for acute hospitals is about CHF 17bn (BfS, 2011). 65% of that sum is consumed by hospitals core activities, medicine and care. And 35%, or CHF 6bn, by their supporting services, which are provided under the roof of facilities management (Lennerts & Abel, 2006). Clear is that in Switzerland patient meal provision is one of the most costly support services due to the high costs of labour, material and patient expectations. The SwissDRG introduction involves two major changes directly affecting this process: - Expected decrease in the inpatients average length of stay, i.e.: Switzerland 2010: 7.5 days, Sweden 2010: 4.5 days (OECD, 2011) - Chance in space utilisation: Up to 2011 space was defined by the user's needs, under SwissDRG the available resources define space allocation as construction has to be fully financed by the prospective payments. Swiss hospitals offer their patients a broad range of different diet meals. Their number varies between 30 and 85 and the definition of diet is diversely outlined by the hospitals as there are no defined standards. With a share between 20-60% of the total food production, administered diets generate a lot of the production cost and need production space. Production cost of the dietary food lies about 23-29% above the cost for normal meals (Biotti & Hofer, 2008). Conclusion: The findings lead to the conclusion that efficiency potential lies in the reduction of costly diets as their use is questioned due to inpatients decreasing average length of stay. Standards need to be defined. The new freed space of hospital kitchens could be used for more profitable activities.