Download Effiency and distribution in Austrian healthcare: An attempt of

Effiency and distribution in
Austrian healthcare:
An attempt of benchmarking
Walter Habacher
Advisor: Prof. Dr. Gerald Pruckner
Austrian Health System
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Austrian patients are very satisfied with their health care
system. The WHO ranks the system among the best in
the world. (WHO 2000)
Comprehensive admission
Nearly no limitation
Comparably short waiting time for elective operations
But expensive
Health costs since 1990 have tripled and GDP has only
doubled, now 11,0% of GDP, Netherlands 12,0%, Poland
7,4%
In absolute figures of public health expenditures: 1990
8,372 billions, 2010 23,957 billions
Results
OECD health data 2011
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Life expectancy
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Healthy life years at birth
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Infant mortality
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Mortality of cancer per
100.000 male
Austria
Switzerland
Hungary
Austria
Sweden
Slovak republic
Austria
Island
Slovak republic
80,4 years
82,4 years
74,0 years
60 years
70 years
51 years
3,8%
1,8%
5,7%
Austria
Sweden
Hungary
194
165
316
Results
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Lung cancer male
Austria
Sweden
45
29
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Breast cancer
Austria
Spain
Denmark
21
16,4
28,6
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Ischemic heart disease
Austria
France
Slovak republic
124
50
324
Smoking
OECD 2009
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Daily smoker
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Teenager below 15 years, girls Austria 30%
Sweden 9%
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Alcohol
Norway 6,7%
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Teenager below 15 years at least twice drunks
Austria
36% girls, 41% boys
Switzerland
18% girls, 29% boys
Italy
8% girls, 22% boys
Obesity
Austria 12,4%
Switzerland 8,1%
UK 23%
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Austria 23,6%
Austria 12,2 l per years
Sweden 13,8%
Thesis
Comprehensive descriptions
 Austria health care system is of high
quality, comparable equitable, but costly
 Why?
 Potential reforms (best practice)
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Health Care Systems
Taxfinanced (Beveridge) NHS
 Social security system (Bismarck)
 Austrian health system is mixed
 58% of public expenditures from social
security
 42% tax financed
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Problems
1.Utilisation of health care services
2. Financing
3. Prevention
Utilisation of health care services
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Consultations with doctors per year
Austria
6,9
Sweden
2,9
Slovak republic 12,1
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Hospital discharges per 1000
Austria
26,5
Netherlands
11,7
OECD-average 15,8
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Hip and knee replacement, MR and CT high above OECD-average
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Drug expenditures have quadrupled since 1990
Financing
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Austrian health care system is complicated
35 different sickness funds
Central government delegates responsibility for
primary care to regional sickness funds
Laender are responsible for secondary care,
receive the money from central government and
sickness funds
Disadvantage: no single payer
Prevention
No general plan to reduce the consum of
alcohol and tobacco
 Health care system is concentrated on
treatment, while neglecting prevention,
which would be more efficient
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Reform options
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General
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One single payer
Managed care
Reducing of consuming excess health care services
Quality management
Outpatient
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Sickness funds
Reducing drug use
Care of chronic diseases
Financing of outpatient departments
Reform options
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Inpatient
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Improvment of efficieny of hospitals
Reducing hospital beds
Specialising of hospitals
Lifestyle
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Promoting al healthy life style
Less alcohol and tobacco
Healthy nutrition
More exercise