Shortages of paediatric primary care and contributing factors in Switzerland: a nationwide paediatrician survey and cross-sectional workforce analysis.

چکیده اصلی

BACKGROUND AND AIM OF THE STUDY: Shortages of primary care paediatricians in Switzerland have been reported by the media, parents, and physicians. We sought to gain a comprehensive understanding of the paediatric primary care workforce by quantifying supply density and assessing paediatricians' views on the shortage and its contributing factors. METHODS: We conducted an online survey from September 2024 to February 2025 among all board-certified members of the Swiss Society of Paediatrics, excluding retired members. The questionnaire included questions on perceived shortage, working conditions, and contributing factors. We estimated the paediatric primary care workforce in full-time equivalents (FTEs) and calculated the supply density across Swiss cantons by combining data from our survey with physician statistics from the Swiss Medical Association and population statistics from the Federal Statistical Office. RESULTS: We contacted 1940 paediatricians, 1155 (60%) of whom answered our survey. Among respondents, 61% were based in practices, 29% in hospitals, and 10% in both settings. We estimated that 1017 full-time equivalent (FTE) primary care paediatricians worked in Switzerland in 2024, resulting in 0.63 FTEs per 1000 children (<18 years). Among primary care paediatricians, two-thirds (70% [95% CI 68-73]) perceived a shortage. Most reported working part-time (87% [86-89]), and respondents saw a median of 22 [IQR 17, 26] patients per full day. Respondents agreed that there is an insufficient number of physicians in Switzerland (69% [66-71]) and a high prevalence of part-time work (65% [62-67]), resulting in insufficient FTEs in paediatric primary care (79% [77-81]). Marked regional differences in supply density emerged, and this variability could be partly attributed to associations with financial disincentives (R2: 0.39) and rural characteristics (R2: 0.33). CONCLUSION: The regional paediatric primary care shortages in Switzerland, which are linked to a limited workforce, prevalent part-time work, financial disincentives, and the rural nature of affected regions, highlight the need for regionally targeted policy solutions.

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