Health Economics. University of Linz & Hospital Data and Evidence in Austria. Gerald J. Pruckner. Lecture Notes, Summer Term 2009

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1 Health Economics Hospital Data and Evidence in Austria University of Linz & Gerald J. Pruckner Lecture Notes, Summer Term 2009 Gerald J. Pruckner Hospitals in Austria 1 / 20

2 Introductory facts I Inpatient care has traditionally played an important role in Austria. For this reason, Austria still has a large number of hospital beds in comparison with the European average. Based on the Austrian population of approximately 8.28 millions, bed coverage per 1,000 residents in 2006 was about 7.7 beds in total and 6.4 acute care beds. In 2006, Austrian hospitals recorded some 2.7 million inpatient stays, 96 % of these in acute hospitals. Hospitalization frequency (hospital stays per 100 residents) was more than 32 %. Gerald J. Pruckner Hospitals in Austria 2 / 20

3 Introductory facts II Problem of international comparability Day clinic admissions and certain outpatient services Follow-up treatment Accounting method and other circumstances de facto multiple-listing of individual hospital stay The steady increase in inpatient stays can be explained in large part by the rising number of day cases up to 2002 (1996 amendment to the Federal Hospitals Act). Austrian hospitals recorded more than 18 million bed days in 2006, a number which has been reducing continuously over many years but has been rising again slightly in Gerald J. Pruckner Hospitals in Austria 3 / 20

4 Characteristics of the Austrian hospital sector I Care sector Acute care hospitals are those hospitals funded by public means via the provincial health funds and other hospitals with an average length of stay of 18 days or less. Non-acute care is provided by all other hospitals. Type of care General care is provided in hospitals with a wide range of medical services (provided in acute care sector only). Specialized care is provided in hospitals dedicated to the examination and treatment of patients with particular illnesses or patients in particular age groups. Gerald J. Pruckner Hospitals in Austria 4 / 20

5 Characteristics of the Austrian hospital sector II Type of hospital General hospitals provide care for all patients without distinction as to sex, age or type of medical care. Special hospitals provide examination and treatment of patients with particular illnesses or patients in particular age groups, or for other special purposes. Sanatoria are specially equipped to provide higher standards of board and accommodation. Long-term hospitals for the chronically ill (4) care for patients in need of medical care and special nursing care. Gerald J. Pruckner Hospitals in Austria 5 / 20

6 Characteristics of the Austrian hospital sector III Financing/funding DRG-based funding by provincial health funds (Landesgesundheitsfonds, formerly Landesfonds) applies to hospitals with public law status, general and specialized, and private general hospitals for public benefit (running on a non-profit basis). DRG-based funding by the private hospitals fund (PRIKRAF) applies to sanatoria (private hospitals run for profit). This fund draws upon the resources of the social insurance system to pay for services carried out in these hospitals that are covered by social insurance. Non-DRG-based funding from other sources applies to various specialized care institutions, especially rehabilitation centres and long-term care institutions. Gerald J. Pruckner Hospitals in Austria 6 / 20

7 Characteristics of the Austrian hospital sector IV Legal status Public law status: Under the Federal Hospitals Act a hospital may be granted public law status if it is non-profit-making and if it meets certain requirements of the Federal Hospitals Act. Public benefit: Under the Federal Hospitals Act a hospital is classified as being for public benefit if, among other things, it is not being operated for the purpose of making a profit, and if any patient requiring admission will in fact be admitted if the hospital is equipped to provide the appropriate treatment. Gerald J. Pruckner Hospitals in Austria 7 / 20

8 Ownership/responsible bodies Gerald J. Pruckner Hospitals in Austria 8 / 20

9 Funding of public benefit hospitals Quelle: Pedit, Pruckner (2007) Gerald J. Pruckner Hospitals in Austria 9 / 20

10 Funding of private hospitals Quelle: Pedit, Pruckner (2007) Gerald J. Pruckner Hospitals in Austria 10 / 20

11 Structural details of the Austrian hospitals 2006 I Gerald J. Pruckner Hospitals in Austria 11 / 20

12 Structural details of the Austrian hospitals 2006 II Gerald J. Pruckner Hospitals in Austria 12 / 20

13 Development of bed capacity in Austria, per 1,000 residents Gerald J. Pruckner Hospitals in Austria 13 / 20

14 Beds per 1,000 residents Gerald J. Pruckner Hospitals in Austria 14 / 20

15 Development of inpatient stays in Austria, per 100 residents Gerald J. Pruckner Hospitals in Austria 15 / 20

16 Residence time in days (stationary care) Gerald J. Pruckner Hospitals in Austria 16 / 20

17 Development of day cases in hospitals funded by provincial health funds Gerald J. Pruckner Hospitals in Austria 17 / 20

18 Development of the average length of inpatient stays funded by provincial health funds Gerald J. Pruckner Hospitals in Austria 18 / 20

19 Percentage of population hospitalised during the last 12 months (16+ years) Gerald J. Pruckner Hospitals in Austria 19 / 20

20 Size structure Gerald J. Pruckner Hospitals in Austria 20 / 20