Health Care System AUSTRIA Dr. Markus Schwarz Institut für Public Health der PMU Christian Doppler Klinik, Salzburg ma.schwarz@aon.at Health Care System Austria - Outline History Health Status in Austria Structure Players Management Financing Revenues Expenses Providers Ambulatry Care Stationary Care Health Care Professionals 1
Health Care System Austria - Status Health Care System Austrian Population 2000-2050 (in 1.000 people) 2
Health Care System Austria subjective Viewpoint IMAS Report Okt. 2003: Österreichische Verbraucheranalyse, Bevölkerung über 14 Jahre Health Care System Austria - Status 3
Health Care System - Standardized Death rates (per 100.000) MALE FEMALE Heart Diseases Neoplastic Diseases Cerebrovascular diseases Other diseases Injuries Gastrointestinal diseases Pulmonal diseases Health Care System Austria - Morbidity 4
Health Care System Austria - Infant Mortality Health Care System Austria subjective Morbidity IMAS Report Okt. 2003: Österreichische Verbraucheranalyse, Bevölkerung über 14 Jahre 5
Health Care System Austria Public Health Health Care System Austria Public Health % of daily smokers EU Switzerland Spain Netherlands Germany Denmark Croatia Austria 0 5 10 15 20 25 30 35 6
Health Care System - Austria Prevention Health Care System - Austria Prevention: Nutrition Consumption Konsum von of Obst/Gemüse fruits/vegetables in kg/person/jahr in kg/person/year 250 200 150 100 50 0 1970 1973 1976 1979 1982 1985 1988 1991 1994 1997 2000 7
Health Care System - Austria Prevention: Nutrition Fruit/vegetableconsumption in kg/person/year (2002) EU United Kingdom Switzerland Sweden Spain Norway Netherlands Italy Germany France Denmark Czech Republic Croatia Belgium Austria 0 50 100 150 200 250 300 Health Care System Austria Disposable budget for private activities IMAS Report Okt. 2002: Österreichische Bevölkerung über 16 Jahre 8
Gesundheitssystem Österreich IMAS Report Okt. 2002: Österreichische Bevölkerung über 16 Jahre Soziale Schicht: A B C D E IMAS Report Juni 2001: ÖVA/ImMAS, Bevölkerung über 14 Jahre 9
Health Care System Austria History Implementation of Social Security as early as 1867 Medical Care through employers Social insurance Cooperative (1873) Bismarck sche social policies 1887 Social Security System (for working poor) Medical Insurance (physician bill, treatments, sick leave payments) Insurance for Injuries at work place (payments for injured and their families) Partial endowments (2/3 employees, 1/3 employer) Autonomous Administration Health Care System - Austria History Introduction of first compulsory social insurance (I. Republik) Introduction of unemployed insurance, insurance for non-workers employees, pension insurance (1927) 1890: 7% Insured 1930: 60% Insured Ab 1945: Deutsches Kassensystem 10
Health Care System - Austria History Social Federation (II. Republik) 1948: Founding of the board of social security insurances( Peoples s insurance ) - +Farmers, government officials Percentage of Insured: 1948: 66%; 1980: 96% Ab 1980: First financial crisis 1978: KRAZAF 1997: LKF System (DRG) 2004: new reform of health care system (ongoing) Health Care System Austria Structure of Social Security Organisations BOARD OF THE SOCIAL SECURITY INSURANCES Insurance of working insuries Health Care Insurance Pension Insurance AUVA - General Insurance for Working Injuries 9 provinicial health care insurances 8 employer based health care insurances Mining employees Entrepreneurs PVA - General Pension Insurance Social Security for railroad workers Social Security for farmers Social Secuity for government officials 11
Health Care System Social Security Funds Number of SS Funds A B D CH F L NL 1992 26 127 1223 191 19 9 27 2002 24 100 355 93 18 9 24 Health Care System Austria PROVIDERS primary - secondary 12
Health Care Providers Overview primary Intramural Hospital outpatient center Follow-up care Speciality center extramural Physician practice Therapeutic practice Diagnostic institutes secondary Hospital stay Day center rehabilitation Long term care Day care centers Health Care Providers Prevention 13
Österreich Leistungen Health Care Providers primary care 14
Health Care Providers Primary Sector Health CreSystem Primary Care - distribution 15
Health Care Providers Secondary Care - Hospital Types Health Care Providers Secondary Care - Hospital Sizes 16
Health Care Providers Secondary Care - Hospitals Health Care Providers Secondary Care - satisfaction IMAS Umfrage 2001, Österreicher über 16 Jahre 17
Österreich Leistungen Stationär Österreich Leistungen Stationär 18
Health Care Providers Secondary Care - Hospital bed distribution Health Care Providers Secondary Care - Hospital beds (1991-2005) 19
Health Care Providers Secondary Care - Hospital Lenght of Stay GUS Staaten Österreich Leistungen Stationär Großbritannien Schweiz Schweden Spanien Norwegen Niederlande Hospital Stationäre stay Aufnahmen per 100 pro 100 inhabitants Einwohner Beds Betten per pro 1000 100 Einwohner inhabitants EU Average Italien Deutschland Frankreich Dänemark Tschechien Kroatien Belgien Österreich 0 5 10 15 20 25 30 35 European health for all database (HFA-DB) World Health Organization Regional Office for Europe Updated: January 2006 20
Österreich Leistungen Stationär GUS Staaten Gro britannien Schweiz Mittlere Average Verweildauer lenght of stay in Tagen days Bettenauslastung Occupation rate in in %% Schweden EU Average Spanien Norwegen Niederlande Italien Deutschland Frankreich Dnemark Tschechien Kroatien Belgien sterreich 0 10 20 30 40 50 60 70 80 90 100 Health Care Provider Secondary Care - Hospital Costs Zur Anzeige wird der QuickTime Dekompressor TIFF (Unkomprimiert) benötigt. 21
Health Care Provider Secondary Care - Pharmaceutical Costs Advance of cost for pharmaceuticals in public hospitals (1991 = 100) 200 180 Österreich Salzburg 160 140 120 100 80 1991 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 Health Care Provider Secondary Care - Hospital Costs Zur Anzeige wird der QuickTime Dekompressor TIFF (Unkomprimiert) benötigt. 22
Health Care Provider Secondary Care - Hospital Financing Health Care Provider Long Term Care 23
Health Care Provider Long Term Care Health Care Providers Professionals 24
Health Care Providers Professionals IMAS Report Okt. 2000, representative Umfrage Sept./Okt. 2000 an Gesamtbevölkerung Österreich über 16 Jahre Health Care Providers Professionals 25
Health Care Providers Professionals Zur Anzeige wird der QuickTime Dekompressor TIFF (Unkomprimiert) benötigt. Health Care Providers Professionals 26
Health Care Providers Professionals -Physicians Health Care Providers Professionals - Nurses 27