Health care systems are systems of high complexity*.

1. creating new realities. communication tools to overcome segmentation in health care systems. the austrian example. workshop ehma-annual conference, athensjune 27th-29th 2008

2. 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”

4. Where does the European Health consumer in 2007 find the most useful Health Care System? reality n°I what citizens say…. Categories • Patient Rights and Information • Waiting Times • Outcome • Generosity of public health care systems • Pharmaceuticals (access, development speed..) AUSTRIA And the winner is…….

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

6. reality n° II what representatives of the sickness funds and economy say…. • 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.

7. estimated financial development of austrian sickness funds. Estimation without measures* Estimation with measures* Source: Hauptverband der österreichischen Sozialversicherung

8. 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.

10. parameters of outpatient and inpatient care, 2003.

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

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

14. 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).

15. Austria is divided into 9 political regions (Länder), meaning that there is not one single health system in Austria, but nine different ones….

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

17. financial flow in the austrian health system.

18. “the reality of the health care provider“ different realities… “the reality of the hospital manager“ “the reality of the representative of sickness fund/ political administrator“

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

20. 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.

21. 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?

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