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Austria’s COVID-19 National Policy
“In January 2018, the new federal government presented its governmental programme, which revealed substantial overlaps with the previous health reform agenda, e.g. concerning strengthening of primary health care, reallocation of resources, focus on public health and health literacy. However, the programme also envisages structural changes with a potentially major impact for the organization of the health care system and SHI [Social Health Insurance] funds (BKA, 2018b). Most importantly, the programme foresees a merging of the nine regional SHI funds which would create only one major Austrian SHI fund (Österreichische Gesundheitskasse) covering almost 80% of the insured population. The government expects efficiency gains and savings in administration. However, a recent major review of the Austrian SHI argues that the large number of insurance funds is not the greatest obstacle to efficiency. Instead the separate procurement of providers (SHI funds versus Länder) and limited risk adjustment pose the most important challenges (LSE Consulting, 2017). The government also plans to further harmonize services and cost-sharing levels across SHI funds (see section 3.4).”
Source: Bachner F, Bobek J, Habimana K, Ladurner J, Lepuschütz L, Ostermann H, Rainer L, Schmidt A E, Zuba M, Quentin W, Winkelmann J. Austria: Health system review. Health Systems in Transition, 2018; 20(3): 1 – 256.
“In Austria, a high utilization of health care services exists due to the restriction-free access to all health insurance services without any associated costs for patients [7]. Data from 2013 from the Lower Austrian Health Insurance Company revealed that 34 low-value services were provided to more than 240,000 beneficiaries [8]. In 2017, the Austrian Choosing Wisely initiative, Gemeinsam gut entscheiden, was founded with the aim of counteracting medical overuse [9]. So far, five Austrian medical societies have developed top lists: geriatrics and gerontology, general practice and family medicine, public health, gynecology and obstetrics, and nephrology.”
Source: Glechner, A., Rabady, S., Bachler, H., Dachs, C., Flamm, M., Glehr, R., Hoffmann, K., Hoffmann-Dorninger, R., Kamenski, G., Lutz, M., Poggenburg, S., Tschiggerl, W., & Horvath, K. (2021). A Choosing Wisely top-5 list to support general practitioners in Austria. Eine Choosing Wisely Top-5-Liste zur Unterstützung von Allgemeinmedizinern in Österreich. Wiener medizinische Wochenschrift (1946), 171(13-14), 293–300. https://doi.org/10.1007/s10354-021-00846-6
“Three of the recommendations on the top-5 list relate to the use of antibiotics. Those recommendations are (1) to only use antibiotics when indicated in patients with respiratory tract infections, (2) to choose the “watch and wait” option before prescribing them in children with otitis media, and (3) to avoid prescribing them in asymptomatic bacteriuria. About 80 to 90% of all oral antibiotics are prescribed in primary care, half of them for respiratory infections and one-sixth for urinary tract infections [18]. The reasons for prescribing antibiotics as identified by research are complex and involve patient expectations, diagnostic insecurity, and limited time resources [19, 20]. Most experts (6 of 9) agreed that pressure from patients was an important reason to select the recommendation to avoid antibiotics for upper respiratory tract infections for the top-5 list, as most patients believe that antibiotics are effective for treating viral infections [21]. Patients frequently expect to be spared another consultation when receiving antibiotics on the spot and the concept of antibiotic resistance is difficult to understand [22]. Significantly, according to doctors’ perceptions, pressure to use antibiotics for mild otitis media in children is often exerted by parents [23]. In addition, our experts assessed medical uncertainty as a reason for overprescribing in the treatment of children with nonsevere otitis media.”
Source: Glechner, A., Rabady, S., Bachler, H., Dachs, C., Flamm, M., Glehr, R., Hoffmann, K., Hoffmann-Dorninger, R., Kamenski, G., Lutz, M., Poggenburg, S., Tschiggerl, W., & Horvath, K. (2021). A Choosing Wisely top-5 list to support general practitioners in Austria. Eine Choosing Wisely Top-5-Liste zur Unterstützung von Allgemeinmedizinern in Österreich. Wiener medizinische Wochenschrift (1946), 171(13-14), 293–300. https://doi.org/10.1007/s10354-021-00846-6
“Another diagnostic procedure for which pressure from patients as well as specialists was considered to have significant impact was not to perform routine screening to detect prostate cancer. The level of information about the benefits and risks associated with a PSA test is often insufficient [27]. This lack of information may compromise a patient’s ability to make informed decisions about whether to perform a PSA test or not and may result in a strong request for testing. Patient requests and worries are factors that have a great influence on primary care physicians for ordering PSA tests in men without any clinical suspicion of prostate cancer [28]. These findings are clearly supported by our study. Our experts considered patients’ expectations to strongly influence decision-making, particularly related to diagnostic testing (imaging for nonspecific low back pain and PSA screening).”
Source: Glechner, A., Rabady, S., Bachler, H., Dachs, C., Flamm, M., Glehr, R., Hoffmann, K., Hoffmann-Dorninger, R., Kamenski, G., Lutz, M., Poggenburg, S., Tschiggerl, W., & Horvath, K. (2021). A Choosing Wisely top-5 list to support general practitioners in Austria. Eine Choosing Wisely Top-5-Liste zur Unterstützung von Allgemeinmedizinern in Österreich. Wiener medizinische Wochenschrift (1946), 171(13-14), 293–300. https://doi.org/10.1007/s10354-021-00846-6
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Page last updated Feb. 1, 2023 by Doug McVay, Editor.
