Outsourcing of Facility Services in Swiss Hospitals

Purpose: To show the present use of outsourcing in Swiss hospitals, particularly services belonging to the area of facility management, with regard to the successive implementation of a new remuneration system, Diagnosis-Related Groups (DRG), by 2012. Design/methodology/approach: This paper is based on a literature review and qualitative research. The design and results of a study carried out in Germany were the reference for the Swiss survey design; in Switzerland 160 healthcare institutions in the German-speaking part of the country were invited to participate. Sixty-one sent back the questionnaire, a response rate of 38%. Thereof 42 respondents from acute hospitals represented half of the number of beds within their type of hospital. The survey had a good balance of private and public institutions, in which psychiatric clinics were very strongly represented and rehabilitation clinics were slightly over-represented. Relevant data were gathered through a comprehensive self-administrated online questionnaire. Findings: Even though DRG will be introduced to acute hospitals only, rehabilitation and psychiatric clinics do not practise different outsourcing habits. The 42 respondents of acute hospitals believe that there will be an increase in outsourcing in the near future, largely because German acute hospitals already outsource far more services than Swiss ones only a year after DRG implementation. Laundry is the service most outsourced by Swiss acute hospitals. Private hospitals tend to outsource more services than public ones. Regionally, hospitals in the canton of Berne had the highest number of outsourced services. Furthermore the result of the study showed the inconsistency of the expected advantages and concern about disadvantages. Research limitations/implications: A potential problem with survey methodology is the existence of non-response bias. The present sample, providing data from 61 (42 acute, 19 psychiatric and rehabilitation) hospitals, is sufficiently exhaustive to represent the outsourcing practices of Swiss hospitals, however.