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{{Short description|none}} <!-- "none" is preferred when the title is sufficiently descriptive; see [[WP:SDNONE]] -->
[[File:Life expectancy in Austria.svg|thumb|350px|Life expectancy development in Austria]]
The nation of [[Austria]] has a [[two-tier health care system|two-tier]] '''health care system''' in which virtually all individuals receive [[Publicly funded health care|publicly funded care]], but they also have the option to purchase supplementary private [[health insurance]]. Care involving private insurance plans (sometimes referred to as "comfort class" care) can include more flexible visiting hours and private rooms and doctors.<ref name="bondi">{{cite web|title=Austrian Health Care|date=September 2009|url=http://aaro.org/aaro-around-the-world/246-austrian-health-care|first=Susie|last=Bondi|publisher=Association of Americans Resident Overseas|access-date=April 2, 2011|archive-date=August 11, 2011|archive-url=https://web.archive.org/web/20110811014743/http://aaro.org/aaro-around-the-world/246-austrian-health-care|url-status=dead}}</ref> Some individuals choose to completely pay for their care privately.<ref name=bondi/>

[[File:Health care cost rise.svg|thumb|right|350px|Austrian health care spending as a percentage of GDP for 1970 to 2015, compared with other nations]]

Healthcare in Austria is [[universal healthcare|universal]] for residents of Austria as well as those from other EU countries.<ref>[http://www.justlanded.com/english/Austria/Austria-Guide/Health/The-Austrian-healthcare-system The Austrian healthcare system Overview of how it works] Accessed: 16 October 2011.</ref> Students from an EU/EEA country or Switzerland with national health insurance in their home country can use the [[European Health Insurance Card]].<ref name="oead.at">[http://www.oead.at/welcome_to_austria/legal_practical_issues/insurance/EN/ Austrian agency for international mobility and cooperation in education, science and research: National health insurance] {{Webarchive|url=https://web.archive.org/web/20141229104957/https://www.oead.at/welcome_to_austria/legal_practical_issues/insurance/EN/ |date=2014-12-29 }} Retrieved: June 26, 2014.</ref> Self-insured students have to pay an insurance fee of EUR 52.68 per month.<ref name="oead.at"/>

Enrollment in the public health care system is generally automatic and is linked to employment,<ref name="KeyFacts">{{cite web|title=The Austrian Healthcare System: Key Facts|url=https://www.bmgf.gv.at/cms/home/attachments/3/4/4/CH1066/CMS1291414949078/austrian_health_care_key_facts_2013.pdf|publisher=Bundesministerium für Gesundheit|access-date=5 May 2018|archive-date=11 July 2019|archive-url=https://web.archive.org/web/20190711203502/http://www.bmgf.gv.at/cms/home/attachments/3/4/4/CH1066/CMS1291414949078/austrian_health_care_key_facts_2013.pdf|url-status=dead}}</ref> however insurance is also guaranteed to co-insured persons (i.e. spouses and dependants<ref name="Your social security rights">{{cite web|url=http://ec.europa.eu/employment_social/empl_portal/SSRinEU/Your%20social%20security%20rights%20in%20Austria_en.pdf|title=Entitled to healthcare|publisher= European Commission|date=2013}}</ref> ), pensioners, students, the disabled, and those receiving unemployment benefits.<ref name="Your social security rights"/> Enrollment is compulsory, and it is not possible to cross-shop the various social security institutions.<ref name="KeyFacts" /> Employers register their employees with the correct institution and deduct the health insurance tax from employees' salaries.<ref name="CityVienna">{{cite web |title=Health Insurance|url=https://www.wien.gv.at/english/health-socialservices/insurance/|publisher=Stadt Wien|access-date=5 May 2018}}</ref> Some people, such as the self-employed, are not automatically enrolled but are eligible to enroll in the public health insurance scheme.<ref name="KeyFacts" /> The cost of public insurance is based on income and is not related to individual medical history or risk factors.<ref name="CityVienna" />

All insured persons are issued an e-Card, which must be presented when visiting a doctor (however some doctors only treat privately insured patients). The e-Card allows for the digitization of health claims and replaces the earlier health insurance voucher.<ref>{{cite web|title=Healthcare in Austria|url=http://www.europe-cities.com/destinations/austria/health/|access-date=5 May 2018}}</ref> Additionally the e-Card can be used for electronic signatures.<ref>{{cite web|title=E-Card als Bürgerkarte|url=https://www.digitales.oesterreich.gv.at/e-card-als-burgerkarte|publisher=Digitales Österreich|access-date=5 May 2018|archive-date=2 April 2020|archive-url=https://web.archive.org/web/20200402233104/https://www.digitales.oesterreich.gv.at/e-card-als-burgerkarte|url-status=dead}}</ref> E-Cards issued after October 2019 will also contain a photo of the card owner to prevent fraud.<ref>{{Cite web|url=https://www.chipkarte.at/cdscontent/load?contentid=10008.723413&version=1569937407|title=Pressegespräch - Jetzt kommt die e-cardmit Foto|date=2 October 2019|website=Chipkarte.at|access-date=11 October 2019|archive-date=3 April 2020|archive-url=https://web.archive.org/web/20200403021834/https://www.chipkarte.at/cdscontent/load?contentid=10008.723413&version=1569937407|url-status=dead}}</ref>

Hospitals and clinics can be either state-run or privately run.<ref name="KeyFacts" /> Austria has a relatively high density of hospitals and physicians; In 2011 there were 4.7 Physicians per 1000 people, which is slightly greater than the average for Europe.<ref name="KeyFacts" /> In-patient care is emphasized within the Austrian healthcare system; Austria has the most acute care discharges per 100 inhabitants in Europe and the average hospital stay is 6.6 days compared with an EU average of 6.<ref name="KeyFacts" />

By 2008 the economic crisis caused a deep recession, and out-of-pocket payments for healthcare increased to become 28% of health expenditures.<ref name="Employment and industrial relations in the health care sector">{{cite web|url=http://www.eurofound.europa.eu/observatories/eurwork/comparative-information/national-contributions/austria/austria-industrial-relations-in-the-health-care-sector|title=Expenditure on health care |publisher= European Foundation for the Improvement of Living and Working Conditions|date=2011}}</ref> By 2010, Austria's public spending has decreased overall, but it was 15.5%, compared to 13.9% fifteen years earlier.<ref name="Health Systems in Transition">{{cite journal| journal=Health Systems in Transition| publisher=World Health Organization| location=Copenhagen, Denmark| pmid=24334772| url=http://www.euro.who.int/__data/assets/pdf_file/0017/233414/HiT-Austria.pdf| title=Austria: health system review| volume=15| number=7| date=2013| last=Hofmarcher| first=Maria M.| editor-last=Quentin| editor-first=Wilm| pages=75–134| access-date=2016-12-03| archive-date=2020-04-13| archive-url=https://web.archive.org/web/20200413185001/http://www.euro.who.int/__data/assets/pdf_file/0017/233414/HiT-Austria.pdf| url-status=dead}}</ref>

==International comparisons==
Austria's health care system was given 9th place by the [[World Health Organization]] (WHO) in their mid-2000s (decade) international ranking.<ref name=bondi/>  In 2015 the cost of healthcare was 11.2% of GDP -the fifth highest in Europe.<ref>{{cite book|last1=Ballas|first1=Dimitris|last2=Dorling|first2=Danny|last3=Hennig|first3=Benjamin|title=The Human Atlas of Europe|date=2017|publisher=Policy Press|location=Bristol|isbn=9781447313540|page=79}}</ref>

The city of [[Vienna]] has been listed as 1st in quality of living (which includes a variety of [[social services]]) by the [[Mercer (consulting firm)|Mercer Consultants]].<ref name=bondi/>

In a sample of 13 developed countries Austria was 5th in its population weighted usage of medication in 14 classes in 2009 and fourth 2013. The drugs studied were selected on the basis that the conditions treated had high incidence, prevalence and/or mortality, caused significant long-term morbidity and incurred high levels of expenditure and significant developments in prevention or treatment had been made in the last 10 years. The study noted considerable difficulties in cross border comparison of medication use.<ref>{{cite web|last1=Office of health Economics|title=International Comparison of Medicines Usage: Quantitative Analysis|url=http://www.abpi.org.uk/our-work/library/industry/Documents/meds_usage.pdf|publisher=Association of the British Pharmaceutical Industry|access-date=2 July 2015|archive-url=https://web.archive.org/web/20151111181650/http://www.abpi.org.uk/our-work/library/industry/Documents/meds_usage.pdf|archive-date=11 November 2015|url-status=dead}}</ref>

It was placed 12th in Europe by the [[Euro health consumer index]] in 2015. The fact that abortion is not carried out in the public healthcare system reduced its rank.<ref>{{cite news|title=Outcomes in EHCI 2015|url=http://www.healthpowerhouse.com/files/EHCI_2015/EHCI_2015_report.pdf|access-date=27 January 2016|publisher=Health Consumer Powerhouse|date=26 January 2016|archive-url=https://web.archive.org/web/20170606082345/http://www.healthpowerhouse.com/files/EHCI_2015/EHCI_2015_report.pdf|archive-date=6 June 2017|url-status=dead}}</ref>

=== Waiting times ===
Despite government claims that no noteworthy waits exist (2007), medium or long waits are normal for at least some elective surgery. Hospital organizations in 2005 stated that mean hip and knee replacement wait times range from 1–12 months, but are generally 3–6 months.  In [[Styria]] and [[Upper Austria]] mean [[hip replacement]] wait times were 108 days (about 3.5 months) and mean [[knee replacement]] 172 days (5.5 months), cor [[cataract surgery]] 142 days (4 months 20 days).  For Upper Austria they were 10.3 weeks (72 days, 2 months 11 days) 21.3 weeks (149 days, almost 5 months) and 12 weeks (84 days, or 2 months 23 days).  A survey by [[Statistik Austria]] found an average wait time of  102 days for eye lens surgery, 78 days (2.5 months) for hip joint surgery, 97 days (3 months 5–5 days) for knee joint surgery, 39 days (1 month 8- days) for [[coronary surgery]], and 28 days (4 weeks) for [[cardiac surgery]]<ref name=":0">{{cite report|last1=Czypionka|first1=Thomas|last2=Kraus|first2=Markus|last3=Riedel|first3=Monika|last4=Röhrling|first4=Gerald|date=2007|title=Waiting Times for Elective operations in Austria: a Question of Transparency|publisher=Institute for Advanced Studies (IHS)|location=Vienna|pages=1–3, 5–9, 11, 18|url=https://www.ihs.ac.at/departments/fin/HealthEcon/watch/hsw07_4e.pdf}}</ref>

Waiting times can be shortened by arranging to visit the same hospital doctor in a private hospital or clinic.  Waits are also sometimes illegally shortened in return for legal or illegal additional payments.  Hospital doctors also receive additional fees to treat privately insured patients even though they are only supposed to receive better amenities/accommodations.  They may therefore treat private patients sooner.<ref>{{cite journal|last1=Stepan|first1=Adolf|last2=Sommersguter‐Reichmann|first2=Margit|date=2005|title=Monitoring political decision‐making and its impact in Austria|journal=Health Economics|volume=14|issue=Suppl 1|pages=S7–S23|doi=10.1002/hec.1026|pmid=16161199}}</ref>  Two Austrian health insurance companies advertised low wait times on their web sites.  In a survey in Lower Austria, 8% of respondents said that they were offered shorter waiting times for additional private payments.<ref name=":0" />  According to Statistics Austria, 2007, in Thomson & Mossialos, 2009, as cited in Health Systems in Transition (HiT) profile of Austria, 2013, social health insurance patients waited twice as long for cardiac catheterization, and 3-4 times as long for cataract and knee surgery.  Compared to individuals with private supplementary insurance, those covered by statutory health insurance wait from three to four times as long for cataract operations and knee operations. For cardiac catheterization procedures, statutory insurance patients wait twice as long.  Some states have created objective waiting list guidelines to counteract this.<ref name="Health Systems in Transition" />

==History==

Austria’s health care system was developed alongside other [[Welfare state|social welfare programs]] by the [[Social Democratic Party of Austria]] in [[Vienna]] (during its classical '[[Red Vienna]]' period) initially.<ref name=health>[http://www.saglik.gov.tr/EN/dosya/2-1008/h/austria.pdf Austria]. European Observatory on Health Care Systems</ref>

Austria's health care began primarily in 1956 with the "Allgemeines Sozialversicherungsgesetz" better referred to as the General Social Insurance Law or ASVG, which mandated that healthcare is a right.<ref name="HEALTH CARE SYSTEMS IN THE EU A COMPARATIVE STUDY">{{cite web|url=http://www.europarl.europa.eu/workingpapers/saco/pdf/101_en.pdf|title= The Health care Systems of the Individual Member States|publisher=European Parliament|date=1998}}</ref>  Individuals become eligible and are automatically registered for healthcare upon employment.<ref name="Your social security rights"/> They get included into the insurance fund known, as Krankenkasse, which results in receiving an insurance card that covers healthcare but also pensions, and unemployment as well. The level of coverage rapidly grew since 1955-1956 ratification of the General Social Insurance Law, and by 1980, it included unrestricted hospital care, and preventive check-ups.<ref name="Health Systems in Transition"/>

[[File:Hospital, Kittsee, Austria.jpg|thumb|right|250px|A hospital in [[Kittsee]], photographed June 2006]]

In 2010 under the chancellorship of [[Werner Faymann]], the [[Social Democratic Party of Austria|Social Democratic]] Health Minister [[Alois Stöger]] began the process of reform as a response to rising healthcare costs and difficulties with capacity. The system is financed in part with public debt, which had become a significant challenge in the aftermath of the [[European debt crisis|recession that hit Austria in 2009]]. Reforms in 2013 aimed to increase capacity, improve the quality of care and address fiscal concerns in concert with the Finance Ministry.<ref name="Hofmarcher">{{cite journal|last1=Hofmarcher|first1=Maria|title=The Austrian health reform 2013 is promising but requires continuous political ambition|journal=Health Policy|date=Oct 2014|volume=118|issue=1|pages=8–13|doi=10.1016/j.healthpol.2014.09.001|pmid=25239031|doi-access=free}}</ref> A key outcome of the reform with the introduction of a budget cap on healthcare expenditure.<ref name="Hofmarcher" /> The idea of structural reform was not entertained. Because of the [[states of Austria|federal structure of Austria]], the legal structure of the social security programme is unusually complex with multiple entities at the state level under the umbrella of the national institution. Thus, making adjustments to the federal framework would present a constitutional issue.<ref name="Hofmarcher" />

==Structure==
Austria's health programs are funded by the sickness insurance fund known as the Krankenkasse, which in 2013 took 11.0% of the GDP, which was above the average of the E.U average of 7.8% of GDP.<ref name="Joint Report on Health Care and Long-Term Care Systems & Fiscal Sustainability">{{cite web|url=http://ec.europa.eu/economy_finance/publications/eeip/pdf/ip037bycountry/joint-report_at_en.pdf|title=Austria Health Care & Long-Term Care Systems|date=2016|publisher=European Commission}}</ref> Austria's healthcare system is decentralized, and operates with a system similar to United States federalism. Each of the nine [[States of Austria|states]] and the federal government of Austria have legal limitation and roles in their healthcare system. Federal Ministry of Labor and Social Affairs is the federal aspect, its role is to develop the framework for the services that are offered, and handle the sickness insurance fund known as the Krankenkasse, which funds Austria's healthcare system. The role of the Provinces is to manage and provide the care as needed.<ref name="HEALTH CARE SYSTEMS IN THE EU A COMPARATIVE STUDY" /> The provision of healthcare is ultimately carried out jointly by federal, provincial, and local actors.<ref name="KeyFacts" /> Since Austria's health program covers a vast array of social insurance including but not limited to unemployment insurance, family benefits, accident insurance, the overall bureaucracy is vast.  While the Krankenkasse is the primary fund, Austria social protection network actually implemented by 22 smaller funds, 19 of which are purely for sickness and all of which by public law are self-governed in order to insure decentralization.<ref name="Your social security rights"/> The funds are also differentiated to allow for effective [[risk pool]]ing, which is why membership is compulsory and citizens are generally unable to select which fund they will belong to.<ref name="KeyFacts" />

==Electronic health records==

[[File:20120217 structure of the Austrian electronic health records (ELGA).jpg|thumb|right|Structure and basic components of the Austrian EHR (ELGA)]]In December 2012 [[Austria]] introduced an [[Electronic Health Record]]s Act (EHR-Act).<ref>[http://www.ilia.ch/wordpress/wp-content/uploads/2013/02/austrian_ehr-act_ILIA.pdf Electronic Health Records Act (EHR-Act)]</ref> These provisions are the legal foundation for a national EHR system based upon a substantial public interest according to Art 8(4) of the Data Protection Directive 95/46/EC.<ref>[http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=CELEX:31995L0046:en:HTML Data Protection Directive 95/46/EC]</ref>

The Austrian EHR-Act pursues an opt-out approach in order to harmonize the interests of public health and privacy in the best possible manner.

The 4th Part of the Austrian Health Telematics Act 2012 (HTA 2012) – these are the EHR provisions – are one of the most detailed data protection rules within Austrian legislation. Numerous safeguards according to Art 8(4) DPD guarantee a high level of data protection. For example:
* personal health data needs to be encrypted prior to transmission (§ 6 HTA 2012), or
* strict rules on data usage allow personal health data only to be used for treatment purposes or exercising patients' rights (§ 14 HTA 2012), or
* patients may declare their right to opt out from the national EHR at any time (§ 15 HTA 2012), or
* the implementation of an EHR-Ombudsman, to support the patients in exercising their rights (§ 17 HTA 2012), or
* the Access Control Center provides EHR-participants with full control over their data (§ 21 HTA 2012), or
* judicial penalties for privacy breaches (Art 7 of the EHR-Act).

{{Portal|Austria|European Union}}

==References==
{{Reflist}}

{{World topic|Healthcare in|title=Health care by country|noredlinks=yes|state=show}}
{{Austria topics|state=expanded}}
{{Europe topic|Healthcare in}}

[[Category:Economy of Austria]]
[[Category:Healthcare in Austria|*]]

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