Health care systems are systems of high complexity*.
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Transcript of Health care systems are systems of high complexity*.
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 [email protected] www.mci.edu