From Big Medical Encyclopedia

SWITZERLAND, the Swiss Confederation — the state in Central Europe. Borders on France, Germany, Austria, Liechtenstein, Italy. The area is 41,3 thousand sq.km. The population apprx. 6,4 million people (1983), including about 700 thousand constantly living foreign seasonal workers. The capital — Bern (147 thousand people). As a part of Confederation 23 cantons, to-rye are subdivided into communities.

Ofits. languages — German, French, Italian.

Date of creation of Sh. is considered on August 1, 1291 when 3 cantons combined in confederation.

Highway — the bourgeois federal parliamentary republic. Each of cantons has the constitution, parliament and the government, however the rights of cantons are limited to the federal constitution adopted in 1874. The legislature belongs to the Federal Assembly (parliament) consisting of two chambers: National council and Council of cantons. Executive power is carried out by Federal council (government) from 7 federal advisers (ministers) elected for 4 years. The head of state and the governments — the president of confederation.

The most part of the country is located in the territory of the Alps. About J/3 of the territory of the country occupies the Swiss tableland. The humid temperate climate with accurate altitudinal zonality prevails.

III. — the advanced industrial country with intensive agriculture. The main industries of the Swiss industry — metal working and mechanical engineering, electric machine industry, chemical (especially pharmaceutical and production of dyes), hour, food and textile. Agriculture provides needs of the country only for 55 — 60%.

The indigenous people is made by 4 ethnic communities: German

Swisses, French-Swiss, ita-lo-Swiss and retoromanets; 65% of indigenous people speak German, 18% — in French, 12% — in Italian and a small number of Swisses speak Rhaeto-Romanic language. Average population density of about 155 on

1 sq.km (1983); on the Swiss plateau 4/5 all population live and almost all large cities are located.

The main vital rates are presented in the table.

The table

Child mortality in 1980 — 1985 made the MAIN VITAL RATES of SWITZERLAND for 1960 — 1983 (for 1000 the population) 8,0 on 1000 live-born. The average duration of the forthcoming life in 1980 made for men 72,3 years, for women — 79,1 years.

The structure of causes of death of the population in Sh. from 1960 for

1980 is characterized by dominance of mortality from cardiovascular diseases, malignant new growths and injuries. Cardiovascular diseases win first place in structure of causes of death: 42,2% in 1960 and 48,3% in 1980. Malignant new growths are on the second place: 19,2% and 23,6%, the third place is taken by accidents, poisonings and injuries: 8,2% and 8,2% respectively. In the country decrease in number of cases of tuberculosis is noted, for the purpose of identification to-rykh are carried out mass rentgenol. inspections. Some other inf. diseases stopped being a burning issue of public health care, except for diseases, sexually transmitted, incidence of which increased a little.

The management of health care is decentralized. The questions connected with the international obligations, and also epidemiol enter a circle of powers of the Federal government. supervision for inf. diseases, control of safety and quality of foodstuff and of sale of toxics, protection against ionizing radiation, development of a pharmacopeia, control of the use of drugs, environmental control, insurance on a case of a disease, from accidents and disability. These duties are assigned to Department of internal affairs of the Federal government, in particular Federal service of public health care and federal bureaus of social insurance, statistics and environment protection. Management of activity in the field of health care at the level of cantons is performed by the State Councils of cantons. Communities create the local bodies of health care; larger communities will organize the health services by analogy to services of cantons. Existence of three levels of public health care (federal, cantonal and communal) extremely complicates implementation of planning in the field of health care. The coordinating bodies are the Conference of cantonal directors of health services, and also semi-official or private institutions: Swiss in-t of hospitals, the Swiss hospital association, the Swiss Red Cross and the Swiss academy of medical sciences which keep in a continuous communication with public authorities.

Nearly 95% of the population of the country are captured by the systems of insurance controlled by Federal bureau of social insurance. Insurance on a case of a disease is voluntary, except for nek-ry cantons where it is obligatory for certain categories of the population. For the working industrial enterprises and handicraftsmen there is an insurance on a case of an injury on production; by this type of insurance it is captured apprx. 50% of workers; 80% of the sum of the paid insurance sick pays are paid insured (in the form of insurance premiums, expenses for insurance) and only 20% — public authorities — federal, cantonal, communal and partially employers. Old-age insurance and disability is carried out by the obligatory national system financed almost for 80% by contributions of the workers and employees, employers and persons working not on hiring, and providing payment of grants to all women 62 years are more senior and to all men 65 years, and also to widows, orphans and disabled people are more senior.

In 1976 in the country would be 474 with 72 438 beds (114,1 beds on 10 thousand zhit.), from them 260 — specialized-tsy on 35 907 beds. Most BC is the public institutions belonging to cantons or communities.

Extra hospital medical aid (according to WHO data, 1977) is rendered by preferential private medical practitioners having agreements with bodies of social insurance. Big distribution was gained by group practice. Obshcheprakti-kuyushchiye doctors work with hl. obr. in average and small communities and in rural areas whereas most of specialists (68% of private medical practitioners) works in the cities. At large there would be policlinics performing free specialized treatment.

The security service of motherhood and childhood contains more than 7 thousand out-patient institutions. Service of school hygiene, including an ostomy tolite. service, the coverage of children of school age during the period * compulsory education provides.

Acute medical aid is carried out by the services of ambulance which are under authority of police officers of bodies and BC or will be organized on a private basis, besides, it is provided with rescue service of the Swiss airline.

Sale of pharmaceuticals and the medical equipment is regulated by Intercantonal bureau of quality control of pharmaceuticals which decisions are put into practice by cantonal authorities.

Dignity. the condition of the country is characterized by the following data: 98,8% of houses are provided a water supply system - ache water, 1,2% use spring water. Most of the population lives in the houses equipped with the sewerage and apprx. 60% uses water treatment соору-^ zheniye.

The major mountain resorts — Davos (see), Lezen, Ve-va; balneal — Egl, Beks, Ragats, Baden, Saint-Moritz; mud — Akkuarossa, the Lava, Ander, etc.

In 1979 in the country there were 14 843 doctors (23,4 on 10 thousand us.), 3700 stomatologists, 1650 midwifes, 40 thousand nurses.

Preparation of medical shots is carried out on 5 medical f-takh high fur boots. Nurses have training within 3 years, and assistants to nurses — 18 months. Midwifes have three-year training in obstetric out-patient clinics. In the country (according to WHO materials, 1977) there are 36 schools for training of nurses of the general profile, 23 schools for the nurses working in security services of mental health, And schools for the nurses specializing in the field of protection of motherhood and the childhood, and 35 schools for training of support nursing staff.

Medical scientific research is conducted by hl. obr. in the university centers and large-tsakh are also financed by cantons, the Federal government (National fund of scientific research) and firms. Applied researches in the field of social and preventive medicine are conducted in in-ta of social and preventive medicine. Major pharmaceutical companies have own research laboratories.

Switzerland is the important international center of political life. In Geneva there is the European department of the UN, a number of the specialized organizations UN — World организация^ health care, the International Red Cross, etc.

Bibliography: The sixth review of a condition of health care in the world of 1973 — 1977 of the p. 2, page 386, Geneva, WHO, 1981; Health services in Europe, v. 2, Copenhagen, 1981; World health statistics annual 1984, Geneva, 1984.

M of H. Savelyev.