Stratégie Nationale Contre Les Maladies Cardio-Vasculaires, L'Attaque Cérébrale Et Le Diabète

Objectives

The National Strategy for Cardiovascular Diseases, Stroke and Diabetes 2017–2024 provides a shared Swiss framework to reduce premature mortality, disease burden, complications, suffering and avoidable costs associated with heart disease, vascular disease, stroke and diabetes. It complements the National Strategy for the Prevention of Non-Communicable Diseases 2017–2024 and seeks to improve quality of life, social participation and productive capacity through prevention, early detection, high-quality care and sustainable use of resources.[1][2][3][4]

• Strengthen health promotion, prevention and early detection by addressing tobacco use, unhealthy diet, insufficient physical activity, excess weight, stress, hypertension, hyperglycaemia and cholesterol, while combining population-wide measures with targeted support for people at increased risk.[5][6][7]
• Promote healthy lifestyles and supportive conditions, including healthier food composition and labelling, activity-friendly environments, health literacy, and measures that improve equal opportunities for disadvantaged groups, migrants, older people and people with health conditions.[7]
• Improve needs-based, integrated and patient-centred care across the continuum from prevention and diagnosis to treatment, rehabilitation, long-term support and palliative care, with particular attention to multimorbidity and patients’ relatives.[8][9][10]
• Optimise emergency and acute care for myocardial infarction and stroke, including public recognition of symptoms, rapid referral, access to certified Stroke Units and Stroke Centres, and effective emergency pathways.[11][12][13]
• Strengthen secondary and tertiary prevention, rehabilitation, self-management, peer support and patient participation to reduce recurrent events, rehospitalisation, disability and premature death.[5][14][15]
• Develop professional competencies and multidisciplinary care, including basic, postgraduate and continuing education for medical and non-medical professionals.[16][17][18]
• Improve health and disease data, quality measurement, registers and targeted research, while addressing funding gaps and strengthening health-policy conditions for prevention and coordinated care.[3][16][19]

Implementation

Implementation is designed as a participatory, interprofessional and interdisciplinary effort led through CardioVasc Suisse and its member organisations, building on existing Swiss health-system structures and operational initiatives. The strategy places people and their complex circumstances at the centre, links prevention with diagnosis, treatment and care, and coordinates action with the national non-communicable disease strategy and other relevant initiatives.[20][21][22][23]

• Coordinate delivery through a proposed Cardio-Cerebrovascular and Diabetes Steering Committee and a coordination body within the CardioVasc Suisse network, supported by thematic working groups and disease-specific lead organisations.[24]
• Assign lead organisations for measures in the strategy tables, with partner organisations supporting delivery; leads are expected to initiate activities, clarify roles, allocate responsibilities and coordinate or delegate tasks.[24][25]
• Phase measures over the eight-year strategy period according to available resources and coordinate them with related national, cantonal and local initiatives.[24]
• Engage professional societies, primary-care providers, hospitals, rehabilitation providers, non-medical health professions, patient organisations, public authorities, insurers, educational institutions, researchers and relevant civil-society organisations.[26][17][27]
• Deliver prevention and early-risk assessment through qualified professionals, primary care, pharmacies, workplace programmes and accessible counselling, supported by harmonised evidence-based recommendations and shared decision-making.[26][28]
• Establish coordinated care pathways by defining responsibilities and interfaces, supporting pilot projects, strengthening regional networks and ensuring systematic referral to prevention, rehabilitation, specialist and palliative-care services where appropriate.[17][10][14]
• Support disease-specific action, including structured diabetes follow-up and complication checks, early detection and treatment of atrial fibrillation, vascular-disease screening and wound-care networks, stroke survivor support, and integrated follow-up for congenital heart disease.[29][30][15][31]
• Monitor implementation through a monitoring and evaluation concept that defines indicators, procedures and interfaces between responsibilities; the coordination body is to review progress periodically and report results to the steering committee and responsible organisations.[25]
• Strengthen evidence and accountability through relevant non-communicable disease indicators, disease registers, quality indicators, registry networking, certification and recertification processes, and targeted health-services research.[19][32][33]
• Mobilise financial and personnel resources from participating organisations according to capacity, seeking additional support from the federal government, cantons, insurers, industry and other partners where needed. No quantified strategy budget or funding-gap amount is specified.[25]

Monitoring & Evaluation

The strategy establishes an implementation-oriented monitoring and evaluation approach centred on periodic progress review, a planned monitoring concept, strengthened disease data and registers, and reporting to coordinating and responsible organisations. It does not provide a consolidated set of numerical targets, a universal reporting frequency or a fully defined accountability framework.[25][19]

• Develop a monitoring and evaluation concept defining indicators, procedures and interfaces between responsibilities.[25]
• Monitor implementation and progress towards shared objectives periodically through the coordination body, while agreeing monitoring arrangements for disease-specific measures with the relevant disease-group leads.[25]
• Report monitoring results periodically to the Cardio-Cerebrovascular and Diabetes Steering Committee and to the organisations responsible for the strategy.[25]
• Monitor and report relevant performance indicators, drawing on the National Strategy for the Prevention of Non-Communicable Diseases indicator set and identifying additional indicators, particularly for care.[19]
• Strengthen Swiss health-data resources, epidemiological data, disease-specific databases and registers to support prevention, care quality, research and policy development.[9][19]
• Establish a national diabetes register recording comorbidities, treatment quality and outcomes, with potential linkage to other relevant registers.[34]
• Network cardiovascular and cerebrovascular registers to improve the availability, analysis and use of epidemiological data.[32][33]
• Develop cardiovascular registries for myocardial infarction, medical devices and ablations, aortic valves and MitraClip, and participate in a future cardiac-arrest register operated by rescue organisations.[32]
• Merge the Swiss Vasc Database and the percutaneous transluminal angioplasty register into a provisional Swiss Vascular Database and promote its national use.[35]
• Define quality indicators and indicative figures for procedures in cardiology and cardiac surgery, alongside evidence-based guidance intended to support patient safety.[32]
• Analyse outcomes, adherence, cost efficiency and risk management to support quality improvement and more effective vascular care.[35]
• Implement the Stroke Registry systematically, initially across relevant stroke-care units and subsequently in other facilities, recording first strokes and conducting follow-up after three months.[33]
• Use compliance with stroke-certification criteria, periodic recertification and sanctions where necessary as quality-control mechanisms.[33]
• Reassess disease burden and required measures when the strategy is updated, including for conditions excluded or deferred during the 2017–2024 priority phase.[36]

Several sections identify intended outcomes, including reduced premature mortality, complications, rehospitalisation and avoidable disease, but the supplied material generally does not translate these aims into quantified outcome thresholds or evaluation timetables.[4][12][14][37]

Costing & Financing

Financing is framed as a strategic requirement for sustainable prevention, coordinated care, data development and implementation, rather than as a fully costed programme. Participating organisations are expected to contribute financial and personnel resources according to capacity, seek external support where needed, and prioritise measures within available resources.[25][24]

• Secure long-term financing for strategic measures as a shared priority within the data, quality and financing action field.[9][38]
• Coordinate resources more effectively, pool existing capacity where possible and improve efficiency across participating organisations.[21][3]
• Phase measures over the eight-year implementation period to 2024 according to available resources.[24]
• Mobilise financial and staff resources from participating organisations and seek additional support from the federal government, cantons, insurers, industry and other partners when internal resources are insufficient.[25]
• Address funding gaps, clarify financing for preventive services and align use of financial resources with the linked non-communicable disease strategy.[39]
• Define cost coverage for priority services, including prevention and early detection delivered by medical and non-medical professionals, care coordination, delegated care, patient education and self-management.[40]
• Seek political and parliamentary support for financing priority services and for strengthening and integrating existing databases and registers.[19][40]
• Consider whether measures can be delivered from existing resources, have low costs or offer substantial savings potential when setting priorities.[9]

The strategy recognises that cardiovascular diseases, stroke and diabetes contribute to rising healthcare costs and that increasing multimorbidity places pressure on healthcare resources and workforce capacity.[22][41][6]Direct healthcare costs for all chronic diseases exceeded 51 billion Swiss francs in 2011, equal to 80% of total healthcare expenditure; cardiovascular diseases and diabetes accounted for 11.3 billion Swiss francs annually, with associated indirect costs estimated at approximately 8 billion Swiss francs per year.[6]

No overall programme budget, quantified funding-gap estimate, allocation formula, financing forecast, unit-cost schedule or detailed economic assumptions are provided in the supplied material.[25][19][40]