Emergency Medicine in Switzerland,☆☆,

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Abstract

Situated in the heart of Europe, Switzerland’s 7 million inhabitants, including 1 million foreigners, live in an area of 41,000 km2. German, French, Italian, and Rhaeto-Romanic are the official languages. The Swiss health service stands out because of the high quality and efficiency of its ambulatory and hospitalized health care management.

[Osterwalder JJ: Emergency medicine in Switzerland. Ann Emerg Med August 1998;32:243-247.]

Section snippets

INTRODUCTION

Modern Switzerland, a federal state consisting of 26 independent cantons, was established in 1848. Situated in the heart of Europe, Switzerland’s 7 million inhabitants, including 1 million foreigners, live within an area of 41,000 km2. German, French, Italian, and Rhaeto-Romanic are the official languages.

THE SWISS HEALTH SERVICE: AN OVERVIEW

The Swiss health service stands out because of the high quality and efficiency of its ambulatory and hospitalized health care management.

EMERGENCY MEDICINE

In principle, the cantons are responsible for providing emergency services. They delegate these tasks mostly to the regional medical associations and public hospitals. In the preclinical field, practicing physicians and rescue services take charge. At the hospital level, the emergency departments of the public hospitals assume a large part of these tasks. There are few legal requirements regulating the provision of emergency care. For this reason the services vary considerably among regions as

EMERGENCY MEDICAL PRACTICE

Emergency medicine under the rules of the cantons consists of manifold elements as to its organizational as well as practical operations.

DISASTER MEDICINE

Cantonal legislation for coping with disasters does not exist. However, most hospitals have a disaster plan readily available. Preparations to cope at sites of a large-scale disaster differ widely. Only a few places, such as the city of Zurich, have a model organization available with qualified physicians. In cases of disaster situations lasting for a period of several days, the military or civil protection agencies may possibly assist. The civil protection agency is a federal and paramilitary

PROSPECTS

In August 1996, the Swiss Medical Association drew up 12 propositions for the improvement of the rescue system. Their demands included legislated uniform regulations to cope with commonplace emergency situations and large-scale disaster events, a universal emergency call number (144) with professional personnel at the central stations, optimal efficiency of the emergency services; and provisions for the continued education in emergency medicine for general practitioners, regulations for the

Acknowledgements

I wish to express my gratitude to Drs L Bemoulli, K Meier, and M Wietlisbach for their valuable encouragement and critical evaluation of this manuscript.

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From the Department of Emergency and Surgery, Kantonsspital, St Gallen, Switzerland.

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Reprint no. 47/1/91228

Address for reprints: J J Osterwalder, MD, MPH Head of Department of Emergency and Surgery Kantonsspital CH-9007 St Gallen, Switzerland 071/494 11 11 Fax 071/494 28 70

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