26 times more basic care for children: private home-care firms billed 378,245 hours in 2024

The curve: flat until 2020, then steep

From 2015 to 2020, private firms billed between roughly 9,000 and 15,000 hours of basic care a year for children and young people. In 2021 it was 32,223, in 2022 84,306, in 2023 194,807 and in 2024 378,245 hours. From 2023 to 2024 the figure almost doubled (+94%). The increase begins two years after a Federal Supreme Court ruling of April 2019 (BGE 145 V 161), under which basic care provided by family members employed by a home-care organisation can in principle be billed to health insurance. The timing fits, but it is not proof.

From a fifth to more than three quarters

In 2019, private firms provided 19.3% of basic-care hours for 0- to 19-year-olds; in 2024 it was 78.2%. Across all age groups, their share of basic care is 43.2% (2019: 28.8%). For children, private firms have thus overtaken non-profit home care far more clearly than for adults.

More children and more hours per child

For long-term care (assessment, treatment and basic care combined), the FSO also reports cases. At private firms, the number of cases aged 0 to 19 rose from 436 (2019) to 3,068 (2024), a sevenfold increase. Billed hours per case rose from 61 to 153. At non-profit home care they stayed almost the same, from 79 to 82 hours. So private firms are not only caring for more children, they are also billing considerably more hours per child. A case is not the same as a child: someone cared for by two providers counts twice.

The cantons: Zurich ahead, French-speaking Switzerland almost none

In the canton of Zurich, private firms billed 165,818 hours of basic care for 0- to 19-year-olds in 2024, 44% of the Swiss total (2019: 6,471). That is 94% of all basic-care hours for this age group in the canton. Non-profit home care in Zurich stayed stable (10,685 and 10,415 hours). Next come St. Gallen (46,328), Aargau (40,270), Thurgau (20,159) and Basel-Landschaft (18,411, 2019: 0). In Bern the figure rose from 19 to 12,141 hours, in Basel-Stadt from 1 to 11,148.

Per 1,000 residents aged 0 to 19, the figure is 210 hours nationwide, 519 in Zurich and 420 in St. Gallen. Glarus (809) and Schaffhausen (727) are even higher, but there a few families are enough to move the figure a lot. In Vaud the figure fell from 2,588 to 733 hours, Geneva reaches 1,921, Neuchâtel 507 and Jura 0. The FSO does not publish figures for Nidwalden and Appenzell Ausserrhoden, and the 2019 figure is missing for several small cantons.

#			Hours 2024
1	Zurich2019: 6,471 · private share 94% · 519 h per 1,000 children		165,818
2	St. Gallen2019: 141 · private share 84% · 420 h per 1,000 children		46,328
3	Aargau2019: 919 · private share 73% · 269 h per 1,000 children		40,270
4	Thurgau2019: 363 · private share 61% · 331 h per 1,000 children		20,159
5	Basel-Country2019: 0 · private share 82% · 316 h per 1,000 children		18,411
6	Schaffhausen2019: not published · private share 89% · 727 h per 1,000 children		12,227
7	Bern2019: 19 · private share 53% · 59 h per 1,000 children		12,141
8	Basel-City2019: 1 · private share 59% · 311 h per 1,000 children		11,148
9	Fribourg2019: 0 · private share 96% · 121 h per 1,000 children		9,128
10	Valais2019: 174 · private share 89% · 113 h per 1,000 children		8,039
11	Solothurn2019: 25 · private share 71% · 137 h per 1,000 children		7,646
12	Glarus2019: not published · private share 100% · 809 h per 1,000 children		6,628
13	Schwyz2019: not published · private share 89% · 125 h per 1,000 children		4,013
14	Lucerne2019: 396 · private share 41% · 45 h per 1,000 children		4,010
15	Zug2019: not published · private share 62% · 105 h per 1,000 children		2,805
16	Ticino2019: 150 · private share 53% · 31 h per 1,000 children		1,969
17	Geneva2019: 148 · private share 28% · 17 h per 1,000 children		1,921
18	Vaud2019: 2,588 · private share 11% · 4 h per 1,000 children		733
19	Uri2019: not published · private share 38% · 95 h per 1,000 children		715
20	Neuchâtel2019: 41 · private share 69% · 14 h per 1,000 children		507
21	Obwalden2019: not published · private share 94% · 28 h per 1,000 children		221
22	Grisons2019: not published · private share 2% · 4 h per 1,000 children		126

Billed basic-care hours by canton as reported by the FSO. Nidwalden and Appenzell Outer Rhodes: not published by the FSO. Small cantons with few children fluctuate strongly. Per 1,000 residents aged 0 to 19 (STATPOP 2024).

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The younger, the faster

Ageing does not explain the increase. At private firms, basic care from 2019 to 2024 grew by 70% for people over 80, by 144% for 65- to 79-year-olds, by 181% for 20- to 64-year-olds and 26-fold for 0- to 19-year-olds. The younger the clients, the faster the growth.

What the figures do not show: who provides care and who pays

Who provides care. The home-care statistics have no variable for family members. On the sharp rise in employees without specific training at private firms, the FSO writes: “Although the available data do not allow direct conclusions, it can be assumed that a considerable proportion of these persons without specific training acted as family carers.” In its report of 15 October 2025, the Federal Council describes organisations that have built their business model on employing family carers, and notes that such employment has risen sharply since 2019. This model could explain part of the increase for children, for example where parents care for their child and are employed by a firm to do so. The public data cannot confirm this.

Who pays. The statistics show hours billed and provided, not who bears the cost. For children, different social insurances may apply depending on the diagnosis. Which of them pays for these hours is unclear.

New firms or newly recorded firms. The number of private companies offering basic care rose from 332 (2019) to 477 (2024). Among private providers there were no firms caring only for children in 2019; in 2024 there were three. The cantons determine, through their lists, which firms take part in the survey. Whether part of the growth comes from firms that were already active and were only recorded later cannot be checked with public data. The FSO has not documented any break in the survey since 2010.

Among people over 80: more care, less household help

The same statistics show a second shift. Home-care nursing hours for people aged 80 and over rose by a third from 2019 to 2024 (+33%), while household help and social support fell by 4.6%. Because the number of people over 80 grew by 15% at the same time, household help per resident aged 80 and over fell from 8.8 to 7.3 hours a year (−17%). That is about 8.4 minutes a week. It is an average across everyone over 80, not what a client receives. Who fills the gap, family members, privately employed household helpers or nobody, the statistics do not show. For the canton of Zurich, Clino described the same trend in July in a separate study.