Healthcare in Austria
The nation of
Healthcare in Austria is
Enrollment in the public health care system is generally automatic and is linked to employment,[4] however insurance is also guaranteed to co-insured persons (i.e. spouses and dependants[5] ), pensioners, students, the disabled, and those receiving unemployment benefits.[5] Enrollment is compulsory, and it is not possible to cross-shop the various social security institutions.[4] Employers register their employees with the correct institution and deduct the health insurance tax from employees' salaries.[6] Some people, such as the self-employed, are not automatically enrolled but are eligible to enroll in the public health insurance scheme.[4] The cost of public insurance is based on income and is not related to individual medical history or risk factors.[6]
All insured persons are issued an e-Card, which must be presented when visiting a doctor (however some doctors only treat privately insured patients). The e-Card allows for the digitization of health claims and replaces the earlier health insurance voucher.[7] Additionally the e-Card can be used for electronic signatures.[8] E-Cards issued after October 2019 will also contain a photo of the card owner to prevent fraud.[9]
Hospitals and clinics can be either state-run or privately run.[4] Austria has a relatively high density of hospitals and physicians; In 2011 there were 4.7 Physicians per 1000 people, which is slightly greater than the average for Europe.[4] In-patient care is emphasized within the Austrian healthcare system; Austria has the most acute care discharges per 100 inhabitants in Europe and the average hospital stay is 6.6 days compared with an EU average of 6.[4]
By 2008 the economic crisis caused a deep recession, and out-of-pocket payments for healthcare increased to become 28% of health expenditures.[10] By 2010, Austria's public spending has decreased overall, but it was 15.5%, compared to 13.9% fifteen years earlier.[11]
International comparisons
Austria's health care system was given 9th place by the World Health Organization (WHO) in their mid-2000s (decade) international ranking.[1] In 2015 the cost of healthcare was 11.2% of GDP -the fifth highest in Europe.[12]
The city of Vienna has been listed as 1st in quality of living (which includes a variety of social services) by the Mercer Consultants.[1]
In a sample of 13 developed countries Austria was 5th in its population weighted usage of medication in 14 classes in 2009 and fourth 2013. The drugs studied were selected on the basis that the conditions treated had high incidence, prevalence and/or mortality, caused significant long-term morbidity and incurred high levels of expenditure and significant developments in prevention or treatment had been made in the last 10 years. The study noted considerable difficulties in cross border comparison of medication use.[13]
It was placed 12th in Europe by the
Waiting times
Despite government claims that no noteworthy waits exist (2007), medium or long waits are normal for at least some elective surgery. Hospital organizations in 2005 stated that mean hip and knee replacement wait times range from 1–12 months, but are generally 3–6 months. In
Waiting times can be shortened by arranging to visit the same hospital doctor in a private hospital or clinic. Waits are also sometimes illegally shortened in return for legal or illegal additional payments. Hospital doctors also receive additional fees to treat privately insured patients even though they are only supposed to receive better amenities/accommodations. They may therefore treat private patients sooner.[16] Two Austrian health insurance companies advertised low wait times on their web sites. In a survey in Lower Austria, 8% of respondents said that they were offered shorter waiting times for additional private payments.[15] According to Statistics Austria, 2007, in Thomson & Mossialos, 2009, as cited in Health Systems in Transition (HiT) profile of Austria, 2013, social health insurance patients waited twice as long for cardiac catheterization, and 3-4 times as long for cataract and knee surgery. Compared to individuals with private supplementary insurance, those covered by statutory health insurance wait from three to four times as long for cataract operations and knee operations. For cardiac catheterization procedures, statutory insurance patients wait twice as long. Some states have created objective waiting list guidelines to counteract this.[11]
History
Austria’s health care system was developed alongside other social welfare programs by the Social Democratic Party of Austria in Vienna (during its classical 'Red Vienna' period) initially.[17]
Austria's health care began primarily in 1956 with the "Allgemeines Sozialversicherungsgesetz" better referred to as the General Social Insurance Law or ASVG, which mandated that healthcare is a right.[18] Individuals become eligible and are automatically registered for healthcare upon employment.[5] They get included into the insurance fund known, as Krankenkasse, which results in receiving an insurance card that covers healthcare but also pensions, and unemployment as well. The level of coverage rapidly grew since 1955-1956 ratification of the General Social Insurance Law, and by 1980, it included unrestricted hospital care, and preventive check-ups.[11]
In 2010 under the chancellorship of
Structure
Austria's health programs are funded by the sickness insurance fund known as the Krankenkasse, which in 2013 took 11.0% of the GDP, which was above the average of the E.U average of 7.8% of GDP.
Electronic health records
The Austrian EHR-Act pursues an opt-out approach in order to harmonize the interests of public health and privacy in the best possible manner.
The 4th Part of the Austrian Health Telematics Act 2012 (HTA 2012) – these are the EHR provisions – are one of the most detailed data protection rules within Austrian legislation. Numerous safeguards according to Art 8(4) DPD guarantee a high level of data protection. For example:
- personal health data needs to be encrypted prior to transmission (§ 6 HTA 2012), or
- strict rules on data usage allow personal health data only to be used for treatment purposes or exercising patients' rights (§ 14 HTA 2012), or
- patients may declare their right to opt out from the national EHR at any time (§ 15 HTA 2012), or
- the implementation of an EHR-Ombudsman, to support the patients in exercising their rights (§ 17 HTA 2012), or
- the Access Control Center provides EHR-participants with full control over their data (§ 21 HTA 2012), or
- judicial penalties for privacy breaches (Art 7 of the EHR-Act).
References
- ^ a b c d Bondi, Susie (September 2009). "Austrian Health Care". Association of Americans Resident Overseas. Retrieved April 2, 2011.
- ^ The Austrian healthcare system Overview of how it works Accessed: 16 October 2011.
- ^ a b Austrian agency for international mobility and cooperation in education, science and research: National health insurance Archived 2014-12-29 at the Wayback Machine Retrieved: June 26, 2014.
- ^ a b c d e f g h "The Austrian Healthcare System: Key Facts" (PDF). Bundesministerium für Gesundheit. Archived from the original (PDF) on 11 July 2019. Retrieved 5 May 2018.
- ^ a b "Health Insurance". Stadt Wien. Retrieved 5 May 2018.
- ^ "Healthcare in Austria". Retrieved 5 May 2018.
- ^ "E-Card als Bürgerkarte". Digitales Österreich. Retrieved 5 May 2018.
- ^ "Pressegespräch - Jetzt kommt die e-cardmit Foto". Chipkarte.at. 2 October 2019.
- ^ "Expenditure on health care". European Foundation for the Improvement of Living and Working Conditions. 2011.
- ^ PMID 24334772.
- ISBN 9781447313540.
- ^ Office of health Economics. "International Comparison of Medicines Usage: Quantitative Analysis" (PDF). Association of the British Pharmaceutical Industry. Archived from the original (PDF) on 11 November 2015. Retrieved 2 July 2015.
- ^ "Outcomes in EHCI 2015" (PDF). Health Consumer Powerhouse. 26 January 2016. Archived from the original (PDF) on 6 June 2017. Retrieved 27 January 2016.
- ^ a b Czypionka, Thomas; Kraus, Markus; Riedel, Monika; Röhrling, Gerald (2007). Waiting Times for Elective operations in Austria: a Question of Transparency (PDF) (Report). Vienna: Institute for Advanced Studies (IHS). pp. 1–3, 5–9, 11, 18.
- PMID 16161199.
- ^ Austria. European Observatory on Health Care Systems
- ^ a b "The Health care Systems of the Individual Member States" (PDF). European Parliament. 1998.
- ^ PMID 25239031.
- ^ "Austria Health Care & Long-Term Care Systems" (PDF). European Commission. 2016.
- ^ Electronic Health Records Act (EHR-Act)
- ^ Data Protection Directive 95/46/EC