A new, more precise BfS statistic makes it clear: In Geneva and Zug, more than three times as many Covid 19 patients were hospitalized in 2020 as assumed.
The number of hospital admissions in connection with Covid-19 in Switzerland is significantly higher than expected. The hospital statistics of the Federal Statistical Office (BfS) show around 31,000 hospitalized people in Switzerland in 2020, based on the figures from the Federal Office of Public Health (BAG), around 20,000 hospital admissions had previously been assumed (the NZZ reported).
A closer look at the figures now shows that the reporting discipline varied greatly depending on the canton. On request, the BfS has broken down its statistics by canton. The data show: while in the canton of Neuchâtel, in Ticino or in Glarus almost as many cases were reported to the BAG as ultimately appear in the BfS statistics, in Geneva and Zug there are only about 30, in the canton of Jura a little more than 40 percent of the cases.
In a comparison of the cantons most affected, the cantons of Geneva and Jura are now catching up with Ticino, the front runner. Previously, they were more in the middle.
It is striking that the hospitals in both Ticino and the canton of Neuchâtel managed to report almost all hospital admissions in connection with Covid-19 to the FOPH, despite the very high burden.
According to statistics, the canton of Zug has so far been the canton with the fewest hospital admissions per 100,000 inhabitants. However, the new figures show that this value was only due to a poor reporting rate.
The BfS assumes that its statistics are complete and correct. The recording process, which has been established for years, is also used for invoicing by the hospitals, and the cases are only reported once a year. The office only had to add the codes for laboratory-confirmed Covid cases and suspected cases – only the former were taken into account in this analysis.
Obligation to report abolished – without effect
The BAG numbers, on the other hand, are collected continuously. Hospitals are obliged to submit a detailed report for each inpatient case (overnight stay in a hospital). However, this is no longer checked.
Originally, the BAG required a clinical report for every positive test, including for outpatients. Missing reports were recorded and the cantons reprimanded those who were obliged to report.
In October 2020, however, this obligation to report was lifted for outpatient cases in order to relieve the administrative burden on the healthcare system. There was still an obligation to report inpatients, but no action was taken against neglectful hospitals. According to one BfS report, “so as not to put even more pressure on them”.
However, the abolition of the reporting requirement did not have a particular impact. Those cantons that showed low reporting discipline after the adjustment had previously reported fewer cases than other cantons. The Swiss average did not change significantly either.
At the Zug Cantonal Hospital, the large difference between the two figures cannot be explained. The doctors responsible in each case reported the patients in accordance with the specifications of the FOPH. “For example, we cannot see from the statistics whether patients residing in the canton of Zug who were treated as inpatients in a non-cantonal hospital were counted or not,” said spokeswoman Sonja Metzger.
The Hôpital du Jura does not want to know anything about a “low reporting discipline”. “During a major crisis, our doctors demonstrate great discipline, especially at the bedside,” said spokesman Olivier Guerdat. In addition, precise data is also delivered several times a day. There were some delays in forwarding the reporting forms to the BAG because the doctors were very busy. However, this will certainly improve somewhat in 2021 and 2022.
According to his spokesman Nicolas de Saussure, the Geneva University Hospital has indeed found a reporting problem. However, one is in the process of resolving this together with the cantonal medical service and the BAG and catching up on the discrepancy. The reports are now being sent reliably and regularly.
Long wait for full stats
It remains unclear whether better reporting discipline can be expected for 2021 and 2022. The processes are likely to be more well-established by now, but the workload on hospital staff remains high, several waves have ensured a consistently high number of patients in 2021, and there was often not enough time to report the cases to the BAG. It will not be clear until the end of the year, the BfS announces the figures for 2021 for the end of November 2022.
Switzerland also has to wait a long time for the statistics from the BfS, which differentiates deaths according to cause and can therefore provide information on how many people really died “from” and not just “with” Corona.
Actually, the figures for 2020 would not have been published until the end of 2022, but in view of political pressure, the figures up to May 2020 have recently been published. In the first wave died according to these around 400 people (or 24 percent) more than previously thought. The BfS announced the figures for the rest of 2020 for the end of August.