Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Lindermuth, M.
(In)equity of Health Care Services Provision - Comparing Austria, Finland,Germany and Norway
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2016. pp.
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Freidl Wolfgang
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- Abstract:
- Aims and objectives This diploma thesis aims to evaluate recent implemented policies and reforms in regard to whether these have lead to more or less equity in health care services provision in the focus countries Austria, Germany, Finland and Norway. Furthermore, challenges of the current systems shall be presented to discuss these recent developments. Gained information shall then be used to propose additional amendments to policies of the recent Austrian health care reforms of 2005 and 2013. Methods Literature review. Variables of assessment are presented in the diploma thesis. Results Research has shown that the health care systems of the focus countries are currently under reform, which is mainly due to financial restrains on state budgets in the aftermath of the economic developments since 2007. With the health care sector reform of 2013, Austria is expecting a higher number of patients in the primary health care sector, though the target percentage - in comparison to the other focus countries - is set rather low. Through "Gruppenpraxen", "Ärzte GmbHs" and the possibility to apply for projects with so-called "reform pools", a higher number of patients frequenting primary health care services shall be achieved. Inefficiencies arise from a multitude of low-threshold health care providers (ambulatory care units in hospitals and general practicioners offer likely services), the lack of a universal data sharing system (ELGA does not include all health care users), and the unresolved Long Term Care issue. Germany's health care system is trying a similar approach - in "Medizinische Versorgungszentren" hospital owners are employing general practicioners and specialized doctors to redirect patient flows. 10% of the German population currently opt-out of public insurance and decided for private insurance, putting pressure on the public health care system as they are considered mainly as contributers (the young, well-earning population). Finland is facing challenges providing health care in remote areas, due to the fact that the number of health care professionals in remote areas is low. A current reform is trying to steer health care professionals to remote areas via certain incentives. Another key objective is the implementation of one administrative body, attending to a patient from e.g. breaking a leg to home care and rehabilitation. However, in general, the Finnish health care system succeeded in improving public health by implementing certain preventive and curative policies. Norway faces fewer limitations in providing health care due to its high tax base and its oil revenues but is in need of structural reforms to keep up with innovation in the health care sector as well as implement a value-for-money approach and proper cost-effectiveness for the post-oil-revenue future. A recent reform aims to improve patient rights by guaranteeing waiting times through implementation of prioritization systems. Furthermore, "national priority areas" have been defined, which shall lead to more funding allocated to psychiatric, preventive, rehabilitation and comprehensive nursing care. All countries have in common that they are facing increasing health care costs due to the current demographic trend. Conclusions One of the focuses in this literature review is how the Austrian health care sector can build on the reforms of 2005 and 2013 and address additional areas for improvement. The importance of prevention is stressed, and combined condition- as well as behaviour-oriented prevention policies are suggested. A general lowering of working hours for physicians and a community based health care system for testing in model regions are recommended. The reform of Long Term Care is brought up and the Dutch System for Long Term Care is presented as an example. Finally, projects to further health literacy among patients, especially the elderly, are mentioned and practical examples from Canada introduced.