Differentiation and case definition

Care categories in the Hospital Medical Statistics

Differentiating care categories

To distinguish between the care categories acute care, rehabilitative care and psychiatry, the cases in the Hospital Medical Statistics are differentiated by hospital type according to the hospital typology, main cost centre (variable 1.4.V01) and the billing tariff (variable 4.8.V01):

  1. The first step is to assign the case, based on the main cost centre, to either psychiatry (M500) or to rehabilitative care M950).
  2. Based on the hospital type, the remaining cases are identified as other psychiatry (K211, K212) or rehabilitative care cases (K221) (step 2).
  3. Cases in specialised geriatric clinics (K234) or cases under the main cost centre geriatric medicine (M900) are then assigned to acute care or rehabilitative care on the basis of the billing tariff (step 3).
  4. Cases that have not been allocated to a care category in the first three steps are assigned to acute care (step 4).
  5. In a fifth step, adjustments regarding the differentiation are made for the individual hospitals based on the results of data plausibility checks, the experience of Obsan from earlier studies as well as investigations in the cantons responsible. These adjustments are documented in a central system (ObsanSITE).

The billing tariff (step 3) has only been included in the differentiation of care categories since the introduction of flat-rate tariffs (SwissDRG) in acute care in 2012. Prior to the data year 2012, cases from the main cost centre M900 as well as cases in specialised geriatric clinics (hospital type K234) are assigned to rehabilitative care. The manual, hospital-specific adjustments described in step 5 also apply from data year 2012 only.

The following definitions are used:


Acute care


Rehabilitative care

Statistic case 1)


A, C


Main cost centre (HKST) 2)




Hospital type according to hospital typology 3)


K211, K212


Billing tariff 4) in combination with HKST M900

M900 & tariff = SwissDRG


M900 & tariff ≠ SwissDRG

Billing tariff 4) in combination with hospital type K234

K234 & tariff = SwissDRG


K234 & tariff ≠ SwissDRG

Hospital and location specific adjustments




1) A: Discharge between 1.1. and 31.12.; C: Admission before 1.1. and treatment that continues after 31.12.

2) M500 = psychiatry and psychotherapy; M900 = geriatric medicine; M950 = physical and rehabilitative medicine

3) K21 = psychiatric hospitals; K221 = rehabilitation clinics; K234 = geriatric clinics

4) billing tariff: 1 = treatment case was invoiced via SwissDRG

Sources: Obsan – ObsanSITE, FSO – Hospital typology

Case definition

In principle, one case represents one hospitalisation. All cases discharged from hospital during one year (A-cases) are included. In psychiatry, additional cases that spend the whole year in the clinic (C-cases) are included.

Cases have been redefined in acute care from 2012 with the introduction of the SwissDRG and in psychiatry from 2018 with the introduction of TARPSY. Cases, which under certain circumstances were rehospitalised within 18 days, are now combined under the same case number. This means that a case can consist of several individual hospitalisations.