title: Swiss healthcare cost containment policies and their impact on anaesthetists' density and satisfaction.
abstract: BACKGROUND
  To control healthcare costs, Federal and Cantonal states have introduced policies to limit expenses and the number of practising physicians. It is unclear to date whether these policies have had a real impact on anaesthetists in Switzerland. The aim of the current study was to assess the density, characteristics and satisfaction of anaesthetists in Latin Switzerland and to compare the results with data collected before the introduction of cost containment policies in 2002.
  
  
  METHODS
  We performed a cross-sectional study between March and July 2009 and included all practicing anaesthetists in Latin Switzerland. A questionnaire consisting of 103 items analysing demographics, activity and job satisfaction was used. The results were analysed and compared to a previous survey conducted in 2002.
  
  
  RESULTS
  Compared to 2002, there was an overall 12% increase in the number of practising anaesthetists who were older and more often females (42% versus 35% in 2002 (p = 0.06)). The number of non-Swiss anaesthetists significantly increased to 19% compared to 11% in 2002 (p <0.05). In contrast, working hours in public hospitals decreased from 59 to 53 hours/week (p <0.001). The majority of anaesthetists considered that their overall personal situation was better than in the previous 10 years and 87.7% considered that these measures had no impact on their future plans.
  
  
  CONCLUSIONS
  Implicit rationing policies introduced in Switzerland to limit healthcare costs and the number of physicians has had no impact on anaesthetists' workforce density, working conditions and overall satisfaction in Latin Switzerland. This opens the question of the real usefulness of these policies, at least for anaesthetists.
authors.affiliation: Division of Anaesthesia, Département d'Anesthésie, Pharmacologie et Soins Intensifs, Hôpitaux Universitaires de Genève, CH. chantal.mamie@hcuge.ch
authors.forename: C
authors.initials: C
authors.lastname: Mamie
authors.forename: F
authors.initials: F
authors.lastname: Clergue
authors.forename: D
authors.initials: D
authors.lastname: Zocatelli
authors.forename: G
authors.initials: G
authors.lastname: Haller
mesh_terms: D000328:Adult; D003363:Cost Control / Q000331:legislation & jurisprudence; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care; D005260:Female; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D009719:Nurse Anesthetists / Q000523:psychology / Q000600:supply & distribution*; D011640:Public Policy; D013557:Switzerland; D016526:Workload