EHMA-Annual Conference, Athens | Anton Petter, MD, MSc, Percivil Carrera PhD, Siegfried Walch PhD

creating new realities. communication tools to overcome segmentation in health care systems. the austrian example.

workshopehma-annual conference, athensjune 27th-29th 2008

EHMA-Annual Conference, Athens | Anton Petter, MD, MSc, Percivil Carrera PhD, Siegfried Walch PhD

Health care systems are systems of high complexity*.

Whenever one talks about change in systems with high complexity, one must consider different

interests and “realities” of stakeholders.

*Kahane- “Solving Tough Problems”

EHMA-Annual Conference, Athens | Anton Petter, MD, MSc, Percivil Carrera PhD, Siegfried Walch PhD

EHMA-Annual Conference, Athens | Anton Petter, MD, MSc, Percivil Carrera PhD, Siegfried Walch PhD

Where does the European Health consumer in 2007 find the most useful Health Care System?

Categories– Patient Rights and Information– Waiting Times– Outcome– Generosity of public health care systems– Pharmaceuticals (access, development speed..)

And the winner is……. AUSTRIA

reality n°Iwhat citizens say….

EHMA-Annual Conference, Athens | Anton Petter, MD, MSc, Percivil Carrera PhD, Siegfried Walch PhD

Source: European Health Consumer Index Study- Health Consumer Powerhouse 2007 http://www.healthpowerhouse.com/media/Rapport_EHCI_2007.pdf

EHMA-Annual Conference, Athens | Anton Petter, MD, MSc, Percivil Carrera PhD, Siegfried Walch PhD

• The finances in the Austrian Health System are are out of order. This is indicated by

- one of the highest contributions of the Austrian working population to the different sickness funds and

- the (near) bankruptcy of one major Austrian Health Funds.

reality n° IIwhat representatives of the sickness funds and economy say….

EHMA-Annual Conference, Athens | Anton Petter, MD, MSc, Percivil Carrera PhD, Siegfried Walch PhD

Source: Hauptverband der österreichischen Sozialversicherung

Estimation with measures*

Estimation without measures*

estimated financial development of austrian sickness funds.

EHMA-Annual Conference, Athens | Anton Petter, MD, MSc, Percivil Carrera PhD, Siegfried Walch PhD

reality n° IIIwhat academic experts say….

• Hospital -bias of the system as indicated by (examples) - High number of hospital beds and hospital admissions- Inadequate Funding of the non hospital based outpatient

sector with less career opportunities for employees outside hospitals.

EHMA-Annual Conference, Athens | Anton Petter, MD, MSc, Percivil Carrera PhD, Siegfried Walch PhD

EHMA-Annual Conference, Athens | Anton Petter, MD, MSc, Percivil Carrera PhD, Siegfried Walch PhD

parameters of outpatient and inpatient care, 2003.

EHMA-Annual Conference, Athens | Anton Petter, MD, MSc, Percivil Carrera PhD, Siegfried Walch PhD

structure of health care expenditure as a percentage of total health expenditure, 1995-2004.

EHMA-Annual Conference, Athens | Anton Petter, MD, MSc, Percivil Carrera PhD, Siegfried Walch PhD

• Hospital -bias of the system as indicated by (examples) - High number of hospital beds and hospital

admissions- Inadequate Funding of the non hospital based

outpatient sector with less career opportunities for employees outside hospitals.

• Underdeveloped public health services as indicated by (examples)- Lowest Measles Immunization rate all over (old)

Europe.

reality n°IIIwhat academic experts say….

EHMA-Annual Conference, Athens | Anton Petter, MD, MSc, Percivil Carrera PhD, Siegfried Walch PhD

EHMA-Annual Conference, Athens | Anton Petter, MD, MSc, Percivil Carrera PhD, Siegfried Walch PhD

reality n°III what academic experts say….

• Hospital -bias of the system as indicated by (examples) - High number of hospital beds and hospital admissions- Inadequate Funding of the non hospital based

outpatient sector with less career opportunities for employees outside hospitals.

• Underdeveloped public health services as indicated by (examples)- Lowest Measles Immunization rate all over (old) Europe.

• Administrative segmentation (financial; power) with too many stakeholders involved (when taking into account comparatively small size of the country).

EHMA-Annual Conference, Athens | Anton Petter, MD, MSc, Percivil Carrera PhD, Siegfried Walch PhD

Austria is divided into 9 political regions (Länder), meaning that there is not one single

health system in Austria, but nine different ones….

EHMA-Annual Conference, Athens | Anton Petter, MD, MSc, Percivil Carrera PhD, Siegfried Walch PhD

organisational structure in the austrian health care sector. where is the power?

EHMA-Annual Conference, Athens | Anton Petter, MD, MSc, Percivil Carrera PhD, Siegfried Walch PhD

financial flow in the austrian health system.

EHMA-Annual Conference, Athens | Anton Petter, MD, MSc, Percivil Carrera PhD, Siegfried Walch PhD

“the reality of the health care provider“

“the reality of the representative of sickness fund/ political administrator“

“the reality of the hospital manager“

different realities…

EHMA-Annual Conference, Athens | Anton Petter, MD, MSc, Percivil Carrera PhD, Siegfried Walch PhD

How can these different realities be mainstreamed to one common goal ?

EHMA-Annual Conference, Athens | Anton Petter, MD, MSc, Percivil Carrera PhD, Siegfried Walch PhD

major (governmental) goals of austrian health system reform.

• Coordination of funding. Clear responsibilities for allocation of resources (ideally from one single source).

• Strengthening of the ambulatory sector. Shift of incentives for citizen not to go to hospitals at the first place

• Strengthening of Public Health Services.

EHMA-Annual Conference, Athens | Anton Petter, MD, MSc, Percivil Carrera PhD, Siegfried Walch PhD

working plan for role play..

• Given the situation described, what are your two main goals for health care reform in the coming 3-5 years?

• What activities do you suggest to reach these goals?

EHMA-Annual Conference, Athens | Anton Petter, MD, MSc, Percivil Carrera PhD, Siegfried Walch PhD

Management Center InnsbruckUniversitätsstraße 15A-6020 InnsbruckTel: +43 512 2070Fax: +43 512 2070-3799office@mci.edu www.mci.edu