Pharmaceutical Pricing and Reimbursement Information (PPRI), Austria, September 2008
(2008; 98 pages)

Abstract

In Austria, health care is based on a social insurance system, which includes health, accident, pension as well as unemployment insurance. The underlying law is the Austrian Social Insurance Law (Allgemeines Sozialversicherungsgesetz, ASVG), effective since 1955. The implementation of social insurance is ensured by the umbrella organisation the Main Association of Austrian Social Security Institutions (Hauptverband der österreichischen Sozialversicherungsträger, HVB) and its 19 sickness funds. Approximately 98% of the population is covered by the social health insurance (SHI); health care contributions are based on the income of the insured person. Exemptions are made for socially disadvantaged persons and persons with communicable diseases.

Besides health insurance contributions, accounting for about 50%, health care in Austria is funded through a mix of personal contributions (30%; out-of pocket payment (OPP) and private health insurance) and general taxation (20%).

In the year 2006, total spending for health care was around 10.1% of gross domestic product (GDP). While public health expenditure accounts for two thirds of total health expenditure (THE), private expenditure (co-payments, private health insurance fees and other out-of pocket expenditure) amounts to one third of THE.

The Federal Ministry of Health, Family and Youth (Bundesministerium für Gesundheit, Familie und Jugend, BMGFJ) is the main policy-maker in health care at federal level. Further key actors in this field are the HVB and the Austrian Federal Agency for Safety in Health Care (Bundesamt für Sicherheit im Gesundheitswesen, BASG) acting as the Austrian Medicines Agency.

In 2007, a total of 40,798 medical doctors provided inpatient and outpatient care for the Austrian population. General practitioners (GPs) offer primary care and act as gatekeepers. In general they have contracts with one or more SHI plans and are remunerated by flat-rate fees and by fee-for-service payments. Specialist care is either administered in hospitals or in consultation offices. The basis for remuneration of public and non-profit-making general hospitals and public specialised hospitals is the diagnosis-related group (DRG) (Leistungsorientierte Krankenanstaltenfinanzierung, LKF / DRG) system...

 
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