What do I need to know about Spitex?
What is Spitex and who pays the costs? This article gives you answers and further information.
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Private Spitex, public Spitex or private nurses? The article outlines the differences between the different Spitex providers.
Most people want to keep living at home for as long as possible. For this reason, as well as demographic trends, the demand for at-home care services is increasing.
'Spitex' is a German acronym that stands for hospital-external care, i.e. help, care, support and advice outside of a hospital or care home. Employees provide their services to those in need of care at home and enable them to remain in their familiar environment.
There are 577 public organizations, 336 private organizations and 1,241 self-employed professional nurses in Switzerland that are recognized by health insurers (Federal Statistical Office, 2020 (in German and French only)).
How do public and private organizations differ?
Public organizations are non-profit organizations. They have a service mandate from the municipality or canton with an obligation to provide care for the population. This means that they must also provide home care, known as Spitex in Switzerland, even if such services do not cover their costs. They therefore receive public-sector funding, which accounts for a third of their income on average. Just under two thirds comes from services provided, and around 2.1% is accounted for by donations.
Private Spitex organizations are run according to commercial principles and do not have a legal obligation to provide care. They are able to turn customers down, and often only accept assignments that are longer than their minimum duration of 2 hours. On average, the income generated by service provision amounts to over 98% of the total. Private Spitex organizations also receive service-based top-up financing from the canton. However, this is much smaller than with public organizations and amounts to only about 0.4% of total income.
Both public and private Spitex organizations require a cantonal operating licence, awarded if they fulfil criteria relating to staff and services and can bill health insurers for the care provided.
What are private nurses?
These nursing professionals have undergone nursing training recognized by the Swiss Red Cross (SRC) and have at least two years' professional experience. The professional licence issued by the canton allows them to bill the care they provide with health insurers directly, under basic insurance. Private nurses earn their income solely from the long-term care services they provide. Customers are always cared for by the same nurse or by a small group of nurses and carers.
How is Spitex organized?
Both public and private Spitex organizations only serve people in selected postcodes. This is referred to as the catchment or operating area. For customers, it does not matter where the Spitex organization is based, but only whether where they live is within its catchment area. Check the Comparis Spitex comparison to find out which organization operates where you live.
Who pays the costs?
The costs for care prescribed by a doctor are paid by:
Health insurance: depending on insured benefits it will cover 52.60, 63.00 or 76.90 francs per hour.
Spitex customer: in addition to the deductible and excess, you pay a patient contribution of a maximum of 15.35 francs per day. The amount to be paid by the Spitex customer themselves depends on the canton, the chosen deductible and their age, and can be calculated using the care cost calculator.
The state: public authorities assume the remaining costs.
Health insurers are obliged by law to cover the following:
Needs assessment, advice and coordination, for example with the doctor and relatives
Examination and medical treatment such as the preparation and administration of medication
Basic care such as showering, bathing, washing, help dressing and undressing, eating and drinking, going to the toilet, getting up, lying down, walking or dental care.
Services not covered by health insurance are day-to-day help and support, such as shopping, cooking, cleaning, washing and ironing. In some cases, these benefits can be covered by private supplemental insurance. Under certain circumstances you may also be able to apply for supplementary benefits and/or helplessness allowances.
From a financial point of view, therefore, only the costs of the care services themselves are relevant when choosing a Spitex organization. The amount you will have to pay for the care services covered by statutory health insurance is always the same regardless of the rate charged for the care services.