SwissPAH: Potentially avoidable hospitalizations in chronic disease – Past and future trends in Switzerland.

Estimating the number of potentially avoidable hospitalizations (PAHs) and their associated resource consumption for the past and next ten year

Project description

Chronic diseases are widespread causing a significant burden both in healthcare expenditures as well as in suffering. In Switzerland, one out of four people suffers from at least one chronic disease, accounting for almost 80% of total healthcare expenditures. While this high number of patients and vast amount of resource consumption are putting immense pressure on the Swiss healthcare system already today, demographic change will aggravate this situation even further as the number of older age groups prone to chronic disease will increase steadily in the next decade(s).

Chronically ill patients require long-term medical supervision and treatment. Primary care plays a key role in this context. In most cases, chronic patients receive inpatient treatment only in case of exacerbations, meaning acute worsening of chronic conditions, which might be linked to unavailable or inaccessible primary care services. Similarly, potentially avoidable hospitalizations (PAHs) of chronically ill patients could also be linked to insufficient quality of primary care services. Additionally, PAHs serve as a useful measure for estimating avoidable chronic disease burden in terms of inpatient capacity (e.g., hospital beds) and healthcare expenditures (e.g., sum of diagnosis-related group (DRG) flat rate payments).

In our project we leverage the OECD definition of avoidable hospitalizations and data from the Federal Statistical Office to analyze how the number of PAHs in Switzerland evolved between 2012 and 2022. For the same period, we also evaluate the resources consumed by PAHs, measured in bed capacities and healthcare expenditures. Furthermore, we will develop an algorithm considering demographic change, among other factors, to project the future trends of PAHs and associated resources over the next decade (2023-2032).

Our study focuses on five chronic diseases: asthma, chronic obstructive pulmonary disease (COPD), chronic heart failure (CHF), hypertension and type 2 diabetes. The evolution of PAHs and associated resources is examined for each chronic condition individually.

The goal of our project is to derive evidence-based recommendations for policymakers, providers, patients, and the healthcare industry to address the challenges associated with PAHs. We believe, this is particularly critical in the context of an aging population, where effective management of chronic conditions is essential for enhancing patient outcomes, ensuring healthcare quality and access, and reducing or at least containing healthcare expenditures. Ultimately, our goal is to make transparent the amount of inpatient capacity and resources that could be saved by enhancing patients' self-management, e.g., by leveraging digital medicine and the role of primary care providers.

Project team

Dr. Justus Vogel, Daria Bukanova-Berend

Cooperation partner


Funding source



6 Monate (01.02.2024 – 31.07.2024)