Costs and Financing of Palliative Care

On behalf of the Federal Office of Public Health (FOPH), we examine the services, costs, and financing of palliative care in Switzerland. In doing so, we estimate both the required level of provision (“normative need”) and the current level of palliative care at the end of life, as well as the associated costs and their financing. We determine the theoretical need (“normative need”) for palliative care services across different care settings (acute inpatient hospital care, nursing homes, hospices, and care at home) and describe the services required to ensure appropriate palliative care. For each setting, we estimate—based on existing data and studies as well as a survey of nursing homes—the number of patients currently receiving care, along with the costs and reimbursements per patient, differentiated by funding sources (health insurance, cantons, municipalities, out-of-pocket payments, and others). Comparing the normative need with the current provision shows that existing services do not fully meet demand across any of the care settings and that the financing of many services is insufficient or inconsistently regulated. This results in regional disparities and hampers the provision of comprehensive, needs-based end-of-life care nationwide.