HOPE
EU hospitals
and healthcare services
HOPE representatives provide information on the last hospital and/or healthcare reforms implemented
in their countries in the last five years and on the elements on the impact of such reforms
inefficiency. However, streamlining the
historically grown constitutional competences
was never feasible.
The growing pressure on health systems
during, and in the aftermath of the economic
crisis, gave impetus for a reform that aimed to
overcome the traditional fragmentation and to
improve coordination and policy coherence. In
2013, thus, a target-based health governance
system for the joint management of the structure,
organisation and financing of the Austrian
healthcare system was established. The system
is based on domestic state treaties, which are
concluded for a limited period of time (4–5 years)
between the federal and the regional
governments with the involvement of the social
insurance institutions, while leaving the
constitutional division of powers and
responsibilities unchanged.
In 2017, the second Federal Target-Based
Governance Agreement was signed. It sets four
strategic goals that are further specified in eleven
objectives, concrete indicators and targets and
almost 80 measures to be taken at federal and/or
regional level over a period of five years. The
strategic goals are:
• Strengthening ambulatory care while reducing
overuse of the inpatient sector and optimising
allocation of resources;
• Ensuring satisfaction of the population by
optimising care and treatment processes;
• Strengthening health promotion and
prevention;
• Ensuring financial sustainability of public
health expenditure.
In December 2018, a reduction of the number
of social insurances funds was decided by the
Parliament inter alia by merging the nine
AUSTRIA
Mr Nikolaus Koller
HOPE Governor
Mrs Ulrike Schermann-Richter
HOPE Liaison Officer, Federal Ministry of Labour,
Social Affairs, Health and Consumer Protection
Could you describe the last hospital and/
or healthcare reforms implemented in your
country in the past 5 years?
Due to the federalist structure of the state and the
self-governed system of compulsory insurance,
the Austrian healthcare system is characterised by
a fragmentation of responsibilities for regulating,
planning, financing and providing healthcare
between the different legislative as well as
administrative levels (federal and regional
governments) and the social insurance funds.
The rather complex blend of different decision-
making structures favours frictional losses and
AUSTRIA
Total current health expenditure as % of Gross Domestic Product (GDP)
General government/compulsory current health expenditure as % of total current health expenditure
Hospital current health expenditure, as % of total current health expenditure
Household out-of-pocket health expenditure as % of total current health expenditure
All hospital beds per 100,000 inhabitants
Acute care hospital beds per 100,000 inhabitants
Acute care admissions/discharges per 100 inhabitants
Average length of stay for acute care hospitals (bed-days)
Practising physicians per 100,000 inhabitants
Practising nurses per 100,000 inhabitants
14
HHE 2019 | hospitalhealthcare.com
2002
9.4%
74.8%
n.a.
18.6%
781.0
667.0
25.3
7.3
403.0
712.0
2008 2016
9.7%
10.4%
75.0%
74.1%
38.7%
38.4%
18.2%
18.9%
769.0
742.0
629.0
555.0
26.7
23.5
6.8
6.4
460.0
513.0
753.0
799.0