Austria HiT (2018)

On the occasion of Austria’s EU Presidency, the European Observatory on Health Systems and Policies has released a new (HiT) health system review. It highlights reforms that aim to improve governance, increase healthy life expectancy and improve quality and efficiency of service delivery.

Health status threatened by unhealthy lifestyles

The Austrian population has a good level of health. Life expectancy at birth is above the EU average and low amenable mortality rates indicate that health care is more effective than in most EU countries. Yet, the number of people dying from cardiovascular diseases and cancer is high compared to the EU28 average. Tobacco and alcohol represent the major health risk factors. Unlike in most other EU countries tobacco consumption has not declined over the last decade and lies well above the EU28 average.

Risk of growing inequalities in access to care

The Austrian health system provides good access to health care services. Austria’s residents report the lowest levels of unmet need for medical care across the EU. Virtually the whole population is covered by social health insurance and enjoys a broad benefit basket. Yet, rising imbalances between the numbers of contracted and non-contracted physicians may contribute to social and regional inequalities in accessing care.

Changing the model of care

The Austrian health system is relatively costly. It has a strong focus on inpatient care as characterized by high hospital utilization and imbalances in resource allocation between the hospital and ambulatory care sector. In recent years important steps have been taken to strengthen primary care and improve skill mix within the health workforce. At the same time efficiency of inpatient care has improved over the reform period, although utilization remains excessively high.

Containing costs and strengthening governance

Reforms aim to contain publicly financed health expenditure growth by imposing a global budget cap, reducing over-utilization of hospital care, and increasing transparency and accountability. Despite efforts to strengthen coordination and cooperation between different levels of government and self-governing bodies by promoting joint planning, decision-making and financing, the Austrian health system remains complex and fragmented in its organizational and financial structure.