Health system in Austria
The Austrian healthcare system guarantees a high degree of fair access and has a strong, ethically based, solidarity health insurance system. In 2011, over 99.9% of the Austrian population had health insurance. However, despite the health reforms between 2005 and 2012 in Austria, there is still room for improvement in the coordination and control of the health system. Fragmented responsibilities make it difficult to identify care needs.
Compared to other European countries, Austria has the highest number of inpatient stays per 100 inhabitants. International comparisons show that in Austria there is an oversupply especially in the intramural area.
Legal basis
Hospitals (intramural area)
The federal government is responsible for basic legislation for hospital matters . Implementing legislation and enforcement are matters of the Länder .
In addition to securing funding requirements, agreements between the federal government and the federal states also aim to ensure an equivalent level of high quality healthcare throughout Austria. A vote that goes beyond national borders is also agreed. A structural fund has been set up for this purpose at the federal level . This is headed by a commission made up of representatives from the bodies involved in the hospital system (federal, state, social insurance , city and community federation , bishops' conference , Evangelical upper church council, medical association, patient advocacy). The structural commission has to define and further develop the basis for the hospital financing system.
The federal states are obliged to issue a hospital plan that contains guidelines for the fund hospitals within the framework of the Austrian health structure plan.
Extramural area
The extramural area is largely federal legislation (e.g. Doctors Act, Psychologist Act, General Social Insurance Act ). In addition to the ordinances of the respective federal ministries, the so-called guidelines of the main association of Austrian social insurance agencies as well as the statutes and health regulations of the social insurance agencies are of great practical legal importance.
As part of the Art. 15a agreement for the years 2008 to 2013, so-called regional health structure plans (one RSG per federal state) were provided, which should include both the intra- and extramural areas. The respective state health platform of the federal state is responsible for passing resolutions on this RSG.
insurance
In Austria there is compulsory insurance for all employed persons , it is not possible to choose the insurance provider . The responsible insurance company depends on the place of employment or the employer .
For self-employed workers also have the insurance. Depending on the chamber affiliation , a choice of insurance carrier may be possible ( compulsory insurance ).
For employed persons, insurance begins when they take up employment; irrespective of the origin of the insurance, the employer is responsible for reporting to the responsible statutory health insurance provider. For tradespeople, the insurance is created by registering the business . Unemployed people and social assistance recipients are automatically insured. Family members such as non-working spouses and children are also insured.
Multiple insurance may result from taking up various types of employment. The amount of the insurance premiums for the year is capped by the maximum premium basis. Additional premium payments must be actively reclaimed from the policyholder in the case of multiple insurance.
financing
| Financial flows in the Austrian healthcare system | |||||||||||||||||||||||||||||||||
| Bonuses | → | Private insurance | Special services | ||||||||||||||||||||||||||||||
| Catalog services ( after DRG ) | |||||||||||||||||||||||||||||||||
| Contributions | → |
Health insurance ( compulsory insurance) |
|||||||||||||||||||||||||||||||
| Taxes | FA → | ||||||||||||||||||||||||||||||||
| → | BM (Fin) | countries | → | BGA | |||||||||||||||||||||||||||||
| Art. 15a BV-G | ↓ | budget | ← | ||||||||||||||||||||||||||||||
|
Country Fund ( LGF) |
|||||||||||||||||||||||||||||||||
| → | → | ||||||||||||||||||||||||||||||||
| ↓ | |||||||||||||||||||||||||||||||||
| population | Deductibles | Fund KA | ← | ||||||||||||||||||||||||||||||
| AN , AG | (←) | → | ← | fee | ← | ||||||||||||||||||||||||||||
| Private KA | |||||||||||||||||||||||||||||||||
| some deductibles * | ← | PRIKRAF | ← | ||||||||||||||||||||||||||||||
| Expense coverage | |||||||||||||||||||||||||||||||||
| or. | (←) | → | Outpatient clinic | ← | |||||||||||||||||||||||||||||
| some deductibles * |
Flat rate + individual services |
||||||||||||||||||||||||||||||||
| (←) | → |
(practicing) doctor |
← | ||||||||||||||||||||||||||||||
|
Exp. f. Drugs + of pharmacy services |
|||||||||||||||||||||||||||||||||
| Prescription fee ** | |||||||||||||||||||||||||||||||||
| patient | (←) | → | pharmacy | ← | |||||||||||||||||||||||||||||
| ↑ | |||||||||||||||||||||||||||||||||
| reimbursement | |||||||||||||||||||||||||||||||||
|
(Fin) Ministry of Finance distributes the budget for the Ministry of Health ; Diagram according to Ziniel (2005)
|
|||||||||||||||||||||||||||||||||
The health system is financed for the extramural area mainly through health insurance contributions and deductibles, and recently increasingly also through tax revenues. The intramural area is mainly financed by federal states and social security.
Health insurance contributions
In the case of employed persons, the health insurance contribution consists of an employee and an employer share. The employee's share is deducted directly from the salary and offset against social insurance by the employer .
| Employee share in the KV | 3.825% for white-collar workers and 3.95% for blue-collar workers |
| Employer's share in the KV | 3.825% for white-collar workers and 3.7% for blue-collar workers |
| Maximum contribution basis for the entire social insurance (PV (10.25%) + KV (3.83 - 3.95%) + AIV (3%)) employee monthly | € 4,020 |
In the case of tradespeople, the health insurance contribution is determined by the Social Insurance Institution of the Commercial Economy (SVA).
| Contribution rate | 9.1% |
| Maximum monthly contribution basis | € 4,235 |
Deductibles
Deductibles exist in various forms:
- Deductibles for medication ( prescription fee )
- Deductibles for medical aids
- Deductibles for visits to the doctor at individual social security institutions (Insurance Company for Public Employees (BVA), Social Insurance Company for Farmers (SVB), Insurance Company for Railways and Mining (VAEB))
- Deductibles for inpatient treatment in hospitals
- e-card fee (for most carriers)
- Previously: health insurance fee (abolished with the introduction of the e-card)
- Previously: Ambulance fee (due to a lack of public and general political acceptance initially provided with numerous exceptions and then abolished again after a short time due to excessive administrative effort, among other things)
Outpatient care
- Average doctor density
On average there is one doctor for every 213 inhabitants. Compared to the last 10 years there was an increase of 26.3%.
- Costs in this area
In 2004, private households and their insurance companies spent around 2 billion euros on outpatient health care. Between 1997 and 2004 this expenditure increased by an average of 3.3% annually.
- Not included: company medical services
Hospitals
Public funding exists for general public hospitals, special public hospitals and private, non-profit general hospitals (2002: approx. 150 funded hospitals for 72% of all Austrian hospital beds or 85% of inpatients treated).
The system of performance-oriented hospital financing has been in use since 1997 . It consists of two levels of funding.
1. The core area. A number of points is awarded nationwide for each inpatient stay, which is composed of the performance component (depending on the diagnosis) and the daily component (length of stay, length of intensive care).
2. The control area. Here, the supply mandate of the hospitals can be addressed country-specifically.
The funds administered at state level to finance fund hospitals draw their contributions from the following sources:
| source | Financing share |
|---|---|
| social insurance | approx. 51% |
| VAT shares (federal, state, municipal) | approx. 8% |
| Additional federal funds | approx. 2% |
| Aid after the health u. Social Aid Act | about 6 % |
| State funds | approx. 15% |
| Community funds | approx. 10% |
| Compensation means | approx. 2% |
| social care | approx. 1% |
| Contributions, refunds, etc. similar | approx. 1% |
| Foreign patients | approx. 3% |
- Structural funds
The structural fund receives its resources from a share of the revenue from sales tax and other federal contributions.
| Structural Fund | 2001 |
| Share of sales tax revenue | € 236 million |
| other federal contributions | € 242 million |
The private hospitals financing fund is the compensation body for the services provided by private hospitals for which social health insurance is obliged to provide benefits.
statistics
Austria
| Hospitals (2011) | 273 | of which with public rights | 45.8% |
| Number of beds in hospitals (2011) | 64,417 | Beds per 100,000 inhabitants (bed density) | 765 |
| Resident doctors and ordinations (2012) | 16,673 | Residents per medical practice | 508 (1) |
| Pharmacies (2011) | 1,292 (+ 24 branches) | Residents per pharmacy | 6518 |
| state | Bed density |
|---|---|
| Vienna | 797 |
| Carinthia | 891 |
| Salzburg | 918 |
| Styria | 875 |
| Upper Austria | 730 |
| Tyrol | 690 |
| Lower Austria | 697 |
| Vorarlberg | 597 |
| Burgenland | 539 |
| Area | 2011 | Change from 2010 |
|---|---|---|
| Total income from statutory health insurance | € 14,949 million | 2.1% |
| of which contributions from employees and employers | € 12,318 million | 3.3% |
| Statutory health insurance expense | € 14,657 million | 2.7% |
| breakdown | in billions of euros | in % |
|---|---|---|
| Medical help | 4,568 | 30.1 |
| Institutional care | 4,446 | 29.3 |
| Administrative burden | 0.430 | 2.8 |
| drug | 3.005 | 19.8 |
| Remedies | 0.240 | 1.6 |
| Other expenses | 2,500 | 16.5 |
| Total expenses | 15,189 | 100.0 |
| Sources: Social insurance, Austrian Chamber of Pharmacists | ||
International comparison
In an international comparison - and also across Europe - the Austrian health system is one of the most expensive, but is also rated as one of the best.
|
|
|
Health Expectations in the EU Member States
- The GLJ estimates are provided for the 27 EU Member States using the EU-SILC data for 2016
(see figure on the left). - The analyzes of the values for healthy life years indicate significant inequalities between the European countries.
- So z. For example, the health expectation of women in Sweden is 16.2 years higher than in Austria .
- The health expectation in Sweden is 16.0 years higher for men than in Austria .
Table of health expectations in the EU member states
See also
literature
- Michaela Seiser: Two-Class Medicine with Comprehensive Care , In: FAZ , July 4, 2006
- Christoph Böhmdorfer: The Eternal Reform , Date , March 2009
- Yearbook of Health Statistics (incl. CD-ROM) 2014. ISBN 978-3-902925-82-4 Download ( PDF 3.5 MB)
- WHO - Health systems in transition - Austria Download ( PDF 4.7 MB)
Web links
- Federal Ministry for Social Affairs, Health, Care and Consumer Protection
- Austrian social insurance (Sozialversicherung.at)
- Social law documentation (sozdok.at)
- Statistics Austria: Health - Statistics
- Austrian Federal Institute for Health Care (ÖBIG)
Cash registers:
- Austrian Health Insurance Fund (ÖGK)
- My social insurance (SV)
- Farmers Social Insurance Institution (SVB)
- Social Insurance Institution for Commercial Businesses (SVA)
- Public Employees Insurance Company (BVA)
Individual evidence
- ↑ Hofmarcher, MM (2013). The Austrian health system: actors, data, analyzes. Medical Scientific Publishing Company. IX.
- ↑ Hofmarcher, MM (2013). The Austrian health system: actors, data, analyzes. Medical Scientific Publishing Company. XXI.
- ↑ Bachner, F., Ladurner, J., Habimana, K., Ostermann, H., & Habl, C. (2012). The Austrian healthcare system in international comparison. Study on behalf of the BMG. Vienna, Health Austria GmbH (GÖG).
- ↑ Reproduced in: Ch. Herber; J. Weidenholzer (Ed.): Assessment approach of the implementation of the health reform 2005 . Linz 2007, p. 133 (PDF, ooegkk.at, accessed on July 20, 2014) - there “Ziniel (2005)” without further details.
- ↑ Reference date January 1st. 2009; Source: Cabinet, Labor and Social Insurance Law, 34th edition July 2008.
- ↑ Source on the maximum contribution basis: Announcement by the Federal Minister for Social Affairs and Consumer Protection and the Federal Minister for Health, Family and Youth on the revaluation according to the General Social Insurance Act, the Commercial Social Insurance Act, the Farmers Social Insurance Act and the Civil Service Health and Accident Insurance Act for the 2009 calendar year ( BGBl. II No. 346 of September 30, 2008).
- ↑ As of 2006.
- ↑ a b c d Statistics Austria: Yearbook of Health Statistics 2011.
- ↑ Austrian Medical Association: Perception Report 2011 and 2012 - Healthcare under the magnifying glass , Vienna February 2013, section Number of doctors working in Austria (structural analysis December 2012) , p. 17 ( pdf ( memento of the original from 10 August 2014 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this note. , 2.1 MB, lbg.at).
- ^ Austrian Chamber of Pharmacists: Pharmacy in Figures 2014 . onA, Chapter 1.1 Pharmacies in Austria : 1. Table, p. 6 ( pdf , 2.1 MB, apotheker.or.at).
- ↑ In Europe only Greece had a higher density of doctors than Austria in 2009; OECD 2011, according to doctors: needs and training positions 2010 to 2030 . Paper on a study by Gesundheit Österreich GmbH on behalf of the Ministry of Health and the Ministry of Science and Research in cooperation with the Austrian Medical Association, press conference, July 20, 2012, Press Center for the Ministry of Social Affairs, section inventory analysis , p. 4 ( pdf ( memento of the original from August 1 2014 in the Internet Archive ) Info: The archive link was inserted automatically and not yet checked. Please check the original and archive link according to the instructions and then remove this notice. , Bmg.gv.at).
- ↑ Austrian Chamber of Pharmacists: Pharmacy in Figures 2014 , Chapter 6.1 Health Insurance Expenditures , table of expenditure on p. 41 ( pdf , 2.1 MB, apotheker.or.at).
- ↑ a b c Source: OWZE Health Data , Paris 2007.
-
↑ a b 191 states were compared; Evaluation criteria: among other things, disability-free life expectancy, needs orientation, costs, fairness of financing, responding to the expectations of the population and patients. The ranking is not undisputed.
World Health Organization (WHO): The World Health Report 2000 , Geneva, 2000. - ↑ a b EuroStat statistics explained: Healthy life years statistics , accessed on April 22, 2019.
- ↑ Regulation (EC) No. 1177/2003 of the European Parliament and of the Council of June 16, 2003 on Community Statistics on Income and Living Conditions (EU-SILC)
