[From policlinic services to medical service centres--the Swiss perspective]

Industrialized countries are confronting the challenge of providing their population with accessible, high-quality, safe and efficient healthcare. They face the growing challenge of caring for an increasing number of patients suffering from chronic and complex diseases. Chronically ill patients see multiple clinicians at different healthcare sites, which increases the risks of errors and poor coordination. These experiences together with rising healthcare costs force the different healthcare systems in the industrialized countries to introduce and test new ways to offer healthcare while taking into account the entire chain of care. Disease management programmes together with institutions and structures like medical homes which are accessible and help to coordinate care make a difference for those patients. The German way to a better coordination of and a better access to healthcare is a step in the right direction, but there is a lack of data demonstrating the increase in effectiveness and efficiency. The opportunity has been missed to conduct pilot studies in order to identify measurable, reliable, and valid outcome indicators and thus create greater transparency. The question is not "whether" but "how" new ways of offering care can be introduced to increase the performance of the whole system, to decrease coordination problems, and to stabilise healthcare spending.