Room for improvement: Transparency in Swiss healthcare falls short

in Healthcare, Industry insights, 09.05.2017

Digging for gold or drowning in data? More transparency in healthcare improves quality of care and stabilizes costs over the long run. But there’s still a long way to go. KPMG’s latest report comparing the data transparency in healthcare across 32 countries finds that Switzerland is not alone in its struggle to make the most of transparency.

Switzerland’s healthcare system is in transition – from financing hospitals to ensuring the quality of care. More transparency will play a key role in assuring quality and stabilizing long-term costs. However, there’s a lot more work to do.

KPMG’s report Through the looking glass: a practical path to improving healthcare through transparency places Switzerland just below average, behind France, Germany, Italy and Iceland. Four Nordic nations – Denmark, Finland, Sweden and Norway – are at the top of the rankings, with Australia, Netherlands, New Zealand, UK, Portugal and Singapore among the second tier.

The study found that even the high performers lack consistency when comparing the availability of data across six dimensions of transparency, including quality care, financial performance and governance. With a wide variation in how far different countries have pursued transparency in healthcare, the findings show that health systems are struggling to make the most of transparency as the global index reveals a patchwork of efforts that often lack strategic coherence.

Switzerland’s got room for improvement

In line with the general trend, Switzerland’s scores vary widely across the six different dimensions of transparency. Despite earning comparatively high scores for transparency in ‘Governance’ (69%), ‘Patient Experience’ (69%), ‘Finance’ (67%) there’s still room for improving transparency in ‘Communication of Healthcare Data’ (36%) and the ‘Quality of Healthcare’ (33%).

Reflecting on Switzerland’s results, it’s clear that even in the areas where the country scored relatively well, more progress must be made:

  • The comparative strong performance on transparency of ‘Governance’ is partly a result of Switzerland’s Freedom of Information Act, which outlines patient rights – including what individual patients are entitled to and can expect from healthcare providers. Information about health service procurement processes is also made available. However, further advances could be made through more public decision-making, including patient/public involvement. Top performers in this aspect were Denmark and New Zealand, both with 94 percent.
  • Patient Experience’ is another higher-scoring dimension, with Swiss healthcare providers obliged to publically report patient satisfaction and approval ratings. Switzerland also has a clear patient complaints system for most (but not all) providers. Nonetheless, there’s still room for improvement, with a need to measure and publish patient-reported outcomes. Switzerland tallies a good index value at 69 percent. Israel leads with 92 percent.
  • With respect to ‘Finance’, Swiss healthcare is comparatively transparent at 67 percent partly due to the public reporting by healthcare providers of prices charged to patients and health insurers/payers, for individual medical conditions and treatments. To gain a higher transparency score, however, all healthcare providers should publish annual reports with independently audited financial accounts.
  • Another positive relates to the transparency of ‘Personal Healthcare Data’ at 57 percent, where Switzerland has published patient data privacy and safeguarding policy – although this is not a legal obligation. Patients in Switzerland are also informed about third party use of their individual health data.
  • There’s considerable room for improvement on the transparency of ‘Quality of Healthcare’. Although all hospital providers collect data on re-admission rates, adverse events, and hospital-acquired infections, this information is not publically reported.
  • Transparency around ‘Communication of Healthcare Data’ could improve by making health care data freely accessible via a dedicated website that is up-to-date and easy to locate and navigate. Publishing this data in open and machine readable formats, and under open license would be a further step forward, allowing independent data processing and analytics.

Imagining a brighter future for healthcare transparency

Transparency may not have delivered on its promise, but that doesn’t mean it’s going away. As the report emphasizes, the trend towards greater transparency is inevitable, given the explosion in the amount of healthcare data and rising consumer expectations of patients and the public.

To realize the full value of this trend, a ‘whole-system’ approach is needed. If Switzerland wants transparency to fulfil its promise to improve quality, it needs a more disciplined, long-term approach. This means measuring what really matters, taking a selective, phased approach to data publication, learning from other innovative providers and promoting high trust cultures.

For more in depth reflections on Switzerland’s results, read Through the looking glass: a practical path to improving healthcare through transparency.

Publication: Transparency Report

About the study

32 leaders of KPMG’s health practices completed a transparency scorecard assessing the performance of each country’s health system across six key dimensions, ultimately creating the full Global Health System Transparency Index. In addition, the study was informed by 25 interviews with global healthcare experts, 16 global case studies from countries like Australia, Denmark, Germany, the Netherlands, UK and US, and an extensive literature review.



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