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Hospital comparison: our QualiCheck

It's worth comparing hospitals. Depending on your reason for going into hospital, some may be better than others. Our QualiCheck tool informs you about treatment quality and patient satisfaction at Swiss acute hospitals.

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The advantages for you

  • QualiCheck can be accessed by anyone, anytime, anywhere.
  • It gives you an intuitive overview in just a few clicks.
  • Twelve different quality criteria help you reach a decision that meets your needs.
  • The evaluation of the number of procedures per year and hospital tells you how well each hospital performs the operation you are about to have.
  • The opportunity to compare hospitals gives you more transparency and lets you see instantly how the individual quality criteria are rated.
  • QualiCheck helps you choose the right hospital.

How it works

From knee replacement surgery to the removal of kidney stones, deciding which hospital to go to is an important step. The more comfortable you are in hospital, the easier the treatment is likely to be. We will help you find a hospital that meets your criteria.

QualiCheck is a public comparison platform

QualiCheck is a publicly accessible, intuitive tool that provides help when it comes to decision-making. The quality information is presented in an easy-to-understand, structured form in just a few clicks. It lets you see at a glance the case numbers for your chosen procedure or treatment, the general patient satisfaction rate and the quality of care. All of the information is based on CSS’s own data and data from public sources.

Disclaimer

Further information on sources, as well as interpretations of the data, can be found under the FAQs. No warranty is given for the accuracy and completeness of the information. Users visit the website and use the information contained on the website at their own risk. Links to other websites and their content are not checked and all liability is disclaimed in this respect. Users bear sole responsibility for using these links. Please note that QualiCheck is intended for information purposes only. In case of emergency, please be sure to alert the known emergency organisations or services.

FAQs

How do we compare hospitals?

CSS champions quality in medical provision. Comparing various quality indicators increases transparency and reveals any shortcomings. This helps ensure a consistently high quality of care for our clients in the long term, as well as generally furthering the quality of care offered in the healthcare sector.

The data published by us is taken from the cited sources in a completely neutral manner (i.e. unweighted and not processed any further). This does not benefit either CSS or any specific hospital in any way.

Our own patient satisfaction survey is one of the sources of the data that we use for QualiCheck. The survey is conducted by an independent market research company, which removes all identifying information. We also draw on publicly available data from a range of independent sources, such as the ANQ – a national association dedicated to furthering the quality of care offered by hospitals and clinics – and the Federal Office of Public Health.

 

What are case numbers?

Case numbers show how many inpatient operations and treatments were performed in which hospital during a particular year. In principle, it can be assumed that a high case number correlates to more experience and expertise and thus indicates a higher quality of treatment. However, when comparing hospitals it is important to consider the invariable effect of size on the case number (e.g. comparing a university hospital with a regional hospital). In addition, the treating physicians at a large hospital may vary, while in a small hospital the same doctor is likely to perform certain treatments or operations regularly.

Case numbers are analysed based on the information provided by the SwissDRG (Swiss Diagnosis Related Groups), which refers to case groups. They form the basis of the Swiss hospitals' flat-rate-per-case system and are linked to diagnoses. It is not always possible to assign all DRG codes clearly to a diagnosis. Therefore, the case numbers in QualiCheck may differ in part from those recorded by the hospitals themselves.

QualiCheck also offers summaries of similar and related operations and treatments – where doing so makes sense – so as to provide the general public with information that is meaningful in terms of scope and detail.

How can I interpret the case numbers for individual locations and hospital groups?

As a rule, each hospital has its own paying agent register number (ZSR no.). Case numbers are collected on this basis. If a group of hospitals work together as a network, it may be that:

  • All the hospitals have the same ZSR no., or
  • Each individual hospital has its own ZSR no., or
  • Some individual hospitals in the network have their own ZSR no.

When it comes to interpreting case numbers, this means:

  • Case numbers are reported for the network as a whole. Therefore, a high case number for the entire network cannot be applied to the individual hospital.
  • Case numbers are disclosed for the individual hospitals/locations.
  • Case numbers are disclosed both for individual hospitals (with their own ZSR no.) and for the network (one ZSR no. for several locations).

Which quality indicators are shown and which are not?

The published patient satisfaction indicators from CSS and ANQ, as well as the CSS assessments, case numbers, wound infection rates, hospital re-admissions and information on pressure sores, differ in terms of their importance and interpretation. CSS and ANQ patient satisfaction figures reflect subjective findings on the quality of the treatment and results. Case numbers, wound infection rates, hospital re-admissions and pressure sores, on the other hand, provide objective measures of quality. No information is provided on the quality of processes and organisational aspects, e.g. hospital facilities, training and development of staff, documentation of medical histories, emergency and palliative care concepts, etc., or on disciplinary and interdisciplinary processes and circumstances. Instead, these are examined by our experienced specialists on site as part of the CSS Insurance quality assessments, and are reflected in the hygiene, care and quality and risk management categories.

Where does the information come from?

The published information on quality issues at Swiss acute hospitals comes from public sources (e.g. ANQ) and CSS's own surveys. It is subsequently adjusted and processed to make it easier to understand (e.g. by rounding up figures to two decimal points, calculating the average of all questions in a particular category, etc.).

Public sources include:

  • ANQ: data on wound infections, pressure sores in categories 1–4, patient satisfaction surveys and hospital re-admissions
  • The Federal Office of Public Health (FOPH): case numbers

The data collected by CSS itself includes:

  • The patient satisfaction survey, analysed by ValueQuest.
  • CSS assessments (in German)

When is the information updated?

All data – i.e. CSS’s own data and data that is publicly available – is generally updated as quickly as possible. If no figures are available for the current period, the previous year’s figures are stated. This means published results may refer to different years.

Number of cases per DRG: 2016
Patient satisfaction CSS: 2015, 2016, 2017, 2018, 2019
Patient satisfaction ANQ: 2018
Pressure sores: 2018
Wound infection rates: 2017, 2018
Hospital re-admissions: 2017
Additional quality information: 2016, 2017, 2018, 2019

Starting in 2019, the CSS patient satisfaction survey will be conducted on an annual basis and over a standard period of six months. If no information is available for the hospital you have searched for, it is either because the hospital was not included in the survey or the response rates were too low. In the latter case, we prefer not to publish the data as the results do not provide sufficient information.

What is an acute hospital?

An acute hospital is a general medical centre in the classical sense that provides services relating to examinations, treatment and patient care. Each acute hospital operates under a cantonal service mandate which authorises it to carry out the relevant surgeries and treatments.

What is the ANQ?

ANQ stands for Swiss National Association for Quality Development in Hospitals and Clinics.

What is the FOPH?

The FOPH (Federal Office of Public Health) is part of the Swiss Federal Department of Home Affairs and, together with the cantons, is responsible for public health in Switzerland and for developing the national health policy.

What is ValueQuest?

ValueQuest is a scientifically based market research company that has been conducting patient satisfaction surveys for CSS for many years.

How are the search results sorted and displayed?

The ranking of the displayed hospitals is based on the case numbers. For example, if you are searching for a particular condition without entering the place, canton or hospital in the text box, you will see the six hospitals (in declining order) with the highest case numbers from anywhere in Switzerland. Unless you enter a condition in the text box, the case numbers shown in the search results field always refer to the whole hospital. If the case numbers of the displayed hospitals are the same, the ranking takes place alphabetically. In the hospital comparison view, you can also sort by quality indicator values in ascending and descending order.

Why does no information on quality appear for the hospital I selected? (Message: "No information")

Possible reasons include:

  • The hospital has not conducted a survey.
  • The information is still being processed and is not yet available.
  • The ANQ has dispensed the hospital and it is thus exempt from the current measurement.
  • The quality of the information is so low that it cannot be displayed.
  • The response rate was so low that the information cannot be displayed.
  • The hospital has explicitly asked not to publish the information, or refuses to do so on principle.
  • CSS has not yet conducted a patient satisfaction survey at this hospital.

Why does the hospital I'm looking for have a different name?

The current name of the hospital is used. Differences may also arise because the hospital has become part of a group or changed its name. If in doubt, we recommend that you search by location.

Why does the hospital I'm looking for not appear at all?

The hospital is either not an acute hospital (but a rehabilitation clinic, for example) or it has closed. Only quality indicators of hospitals that are in operation are shown.

Why are only these and not other hospitals in the area shown?

You start your search by entering your condition and location. However, if the location does not have a hospital nearby, the search is expanded until at least one hospital is found for which case numbers exist for the condition you are querying.

Why is the highest positive bed sore rate shown in red, thus indicating a bad result?

Values of less than zero indicate that pressure sores occur less frequently than average for all hospitals. Values of more than zero indicate that pressure sores occur more frequently than average for all hospitals.
"- 2" is therefore better than "-1", "-1" is better than "1", and "0" is average.

How does the mobile QualiCheck work?

The mobile version gives you all the functions of the desktop version, except for the map and the mannequins.

What is the background to CSS's own survey, and which key figures and information from the patient satisfaction survey are shown?

CSS has been surveying its insured persons since 2014 about their general satisfaction after an acute hospital stay. Insured persons aged 18 and over who have spent at least one night in hospital during the preceding three months are included in the survey. An insured person will be asked about their hospital or rehabilitation experience only once during any particular year.

When interpreting these results, please note that they are not risk-adjusted. Adjusting quality indicators to take account of risk means that patient-specific factors such as age, length of stay or prior illnesses, as well as differences in the distribution of these risks (patient mix) between hospitals are also factored into the calculation. Therefore, a lower level of patient satisfaction does not necessarily translate to a poorer quality of result.

The questionnaire contains 21 main questions, broken down into various categories (e.g. “Administrative procedures”, “Doctors”, etc.). A single category may contain several questions whose results are reported as mean values. 

You can find details of the various questions and categories in the patient satisfaction questionnaire (in German).

As incomplete questionnaires (e.g. only four of the seven questions in the "Doctors" category answered) are included in the analysis, the number of responses indicated may vary. The scale of 1–6 (the same system used in Swiss schools) has 1 as the poorest rating ("not at all") and 6 as the best rating ("fully").

On the whole, we regularly achieve good response rates to our surveys. However, please note that not all hospitals receive a large number of ratings. This is because they do not all treat the same number of patients insured with CSS who are subsequently surveyed.

Note: persons insured with CSS who have stayed at an inpatient rehabilitation facility have also been surveyed since 2016. These results are not yet published in QualiCheck.

What is the background of the ANQ survey, and what information is shown?

From 2020, the ANQ patient satisfaction survey will be conducted every second spring. The target group is made up of patients aged 18 who have spent at least one night in hospital and were discharged in September.

The survey consists of six questions with a range of possible answers. For the first five questions, the respondent must choose between 1 (most negative) and 5 (most positive); for the sixth question, the respondent must choose between 1 (too short) and 3 (too long). Based on these response options, QualiCheck shows only the average of the first five questions as the result. The average comprises all the questions, weighted equally, for the location in question.

The questions are:

  • How would you rate the quality of the treatment you received from the doctors and nurses?
  • Were you given the opportunity to ask questions?
  • Did you receive satisfactory answers to your questions?
  • Did you receive satisfactory explanations about the purpose of the medication you were supposed to take at home?
  • How well was your discharge organised?
  • How do you feel about the length of your hospital stay?

As the ANQ aims to record and compare measurements from satisfaction surveys conducted throughout the country, all the results are risk-adjusted. In relation to acute care, this risk adjustment takes account of the person's age, gender and location after discharge, among other factors. Hospitals with fewer than 50 evaluable questionnaires are not included in the measurements.

What is the background of the CSS assessments, and what benefits do they offer service providers and patients?

As Switzerland's largest health insurer, CSS aims to provide clients and patients with clear quality data and greater transparency about quality assurance in hospitals, rehabilitation clinics and psychiatric treatment facilities.

CSS experts evaluate a range of quality criteria from the customer perspective and collate them into an overall list. These criteria are examined and scored in on-site assessments at the hospitals concerned. They offer added value to customers and hospitals alike. We believe that our assessments provide customers and patients with a 360-degree view of the action that the clinic has taken to ensure – and continue enhancing – the quality of its care. Furthermore, they give hospitals, rehabilitation clinics and psychiatric treatment facilities an opportunity to show how they are committed to serving their patients on a day-to-day basis.

What is a pressure sore?

A pressure sore (decubitus) is a skin injury that also affects the underlying tissue. Inadequate or incorrect care (e.g. if the patient is incorrectly positioned or spends a long time lying on one side) may be among the possible causes. This is why the frequency and type of pressure sores also serves as an indicator of the quality of care. The published values for categories 1–4 (i.e. all types of pressure sores, including lesser (1) and more severe cases (4)) relate to the hospital as a whole and not to a specific condition. This indicator is particularly relevant for patients facing an extended stay in hospital and/or patients who are at greater risk of developing pressure sores.

How are pressure sores measured and how are the results interpreted?

The prevalence measurement is conducted on one specific day each year. The results are disclosed as a risk-adjusted residual value, which means patient-specific factors such as age, length of stay, etc. are also factored into the calculation. Values of less than zero indicate that pressure sores occur less frequently than average for all hospitals. Values of more than zero indicate that pressure sores occur more frequently than average for all hospitals: “-2” is therefore better than “-1” and “-1” is better than “1”. “0” is average. Please note that the measurement date may lead to distortions because not all patient groups can be taken into account on a single day.

What does "hospital re-admission" refer to?

No patient wants to be re-admitted to hospital. It means having to return after being discharged because of a problem that was known during the original stay. It is not the desired outcome for anyone concerned, and may have a number of reasons. These are not always the fault of the hospital, however, neither are they always avoidable. That is why a hospital's re-admission rate will never be zero. The normal figure is 1.0. If patients are being re-admitted frequently, the hospital needs to investigate the cause before negative conclusions are made about the quality of preparations for discharge.

Re-admission is potentially avoidable if it:

  • Was not foreseeable when the patient was last discharged
  • Occurs within 30 days of discharge
  • Is caused by at least one condition that was known upon discharge

The calculation covers all inpatients, including children. It does not include:

  • Deceased patients or those who transferred to another hospital 
  • Healthy newborns 
  • Day-case surgery patients 
  • Patients whose place of residence is abroad

The primary aim of the indicator (rate) is to check the following points:

  • Was the discharge prepared well?
  • Were the diagnoses clear?
  • Did the patient receive appropriate treatment upon their discharge?
  • Was any post-discharge outpatient care planned?
  • Did the attending physician brief the family or, where necessary, the health visitor service?

What is the wound infection rate?

A post-operative wound infection refers to a condition that sets in and affects the treated body part or organ within one month – or 12 months in the case of defined types of surgery – after the operation. The displayed risk-adjusted wound infection rate refers to the entire hospital and includes all infection types, i.e. both superficial ones and those that occur deep within organs or cavities. Adjusting risk aspects to the quality indicators means that patient-related factors such as age, length of stay, prior illnesses, as well as differences in the distribution of these risks (patient mix) among the hospitals is also factored into the calculation.

All hospitals affiliated with the ANQ are obliged to participate in the measurement. Out of a total of ten index operations, two are voluntary; out of the remaining eight, three must be selected and included in the measurement. All hospitals whose services include surgery of the large intestine are obliged to carry out this wound infection measurement.

QualiCheck gives you the wound infection rates in the detailed view of the hospital. To enable you to compare hospitals in terms of a selected condition (e.g. digestive tract issues), we chose to show what we believe is the most frequently measured or occurring wound infection rate (the large intestine in this case). In addition, the available wound infection rates are shown in the blue box once you have selected a condition. The detailed view of the hospital provides an overview of all the measured and displayed wound infection rates.

What is medical rehabilitation?

Medical rehabilitation is designed to improve a patient's health following surgery, a serious illness or an accident. Doctors, nursing staff and therapists (such as physiotherapists and occupational therapists, as well as speech therapists) work closely together to achieve this. While undergoing rehabilitation, patients receive a targeted programme of treatment to allow them to return to an independent lifestyle as quickly as possible. In addition to medical care, patients (and sometimes also their families) receive advice and support from social services. The aim is for the individuals concerned to require minimum support with their daily lives.

Rehabilitation may be offered on an outpatient, partial inpatient (in day care hospitals) or inpatient (at a rehabilitation clinic) basis.