On the Strategies and Efficiency of Care and Support Systems for Elderly Across Cantons in Switzerland

Abstract

The Swiss Federal Council has formulated a policy requiring each canton to establish housing conducive to independent living during old age. Maintaining the independence of older adults at home rather than transitioning to more expensive institutional care has gained traction. This study investigates the heterogeneity of strategies arising from the autonomy granted to each canton. Using mandatory statistics from the Swiss Federal Statistical Office for 2020 on 1550 institutions for the elderly and 2546 at-home care providers, we rank the 26 cantons by permanent and temporary care and support, distinguishing between at-home and institutional care. We use univariate regressions to explain differences and perform efficiency analyses of the respective systems. We find that the French- and Italian-speaking cantons prioritise at-home care, while the German-speaking regions rely more on institutional care. The analyses reveal an inefficient stationary approach in German-speaking cantons, which often places elderly individuals with minimal care needs in institutions. Conversely, with an ambulatory approach favouring independence, cantons like Vaud and Valais prioritize counselling and at-home services, deferring entry into institutions and allowing for short convalescence stays. Our findings are relevant for governmental infrastructure planning and the property owners, investors, and property managers involved in senior housing decisions.