Implications of Primary Care Scenarios for the 'Performance' of Chronic Care Delivery in Switzerland: A Systems Modelling View

Switzerland and most high-income countries are confronted with a growing number of people with chronic conditions who must be treated by healthcare systems that are designed to provide acute care predominantly. A widely supported solution is strengthening the primary care sector to better meet these increasingly complex healthcare needs. We used system dynamics to develop a computer simulation model of the driving factors and their connections to the quadruple aim of Switzerland's chronic care. The model served as an exploratory scenario analysis tool. A critical insight from the scenario analysis is that the capacity of the primary care sector can only be enduringly enhanced if the workforce is expanded and resources are shifted from inpatient and specialist care to primary care. This study should help policymakers better understand fundamental structural mechanisms and cause-effect relationships arising from changes to primary care.