Health Expenditure in Austria

Current expenditure on health – public

Current expenditure on health by the general government consists of expenditure by the central government, provincial governments, local governments and social security funds. In 2010, current public expenditure on health amounted to 23 bn. Euros. Total public expenditure, which besides current expenditure includes expenditure on investments, amounted to 24 bn. Euros and corresponds to 76.2% of total expenditure on health.

The 23 bn. Euros can be subdivided in the following health care functions. About 47.1% of current public expenditure was spent on in-patient care, 24% on out-patient care, 9.2% on long-term nursing care and 13.6% on pharmaceutical products, medical durables and non-durables. 1.3% of public current expenditure on health was spent on patient transportation and emergency rescue, 2% on prevention and public services and 2.9% on general health administration and insurance. In 2010 current public expenditure on health care increased by 2.2% compared to the previous year.

Public expenditure on in-patient care increased from 3.5 bn. Euros in 1990 to 10.8 bn. Euros in 2010. Therefore, public expenditure on in-patient care on average increased by 5.7% annually. Compared to the prior year, expenditure on in-patient care rose by 2.9%. Public expenditure on out-patient care in 2010 amounted to 5.5 bn. Euros. Between 2009 and 2010 public current expenditure on out-patient care increased by 1.5% and during the period of 1990 to 2010 it increased by an annual average rate of 4.8%.

Public current expenditure on long-term nursing care augmented by 7.2% in 2010 compared to the year 2009. Therefore, public expenditure on long-term nursing care amounted to 2.1 bn. Euros in 2010. This category contains for example expenditure on attendance allowance or home nursing care.

Between 2009 and 2010 public current expenditure on pharmaceutical products, medical durables and non-durables increased by 0.8% to 3.1 bn. Euros. On average there was an increase in public expenditure of 7.2% between 1990 and 2010. Due to a value added tax reduction on pharmaceutical products from 20% to 10%, which entered into force on 1.1. 2009, public expenditure decreased by 4.6% in the previous year.

Expenditure on prevention and public health increased by 0.2% from 451 m. Euro in 2009 to and 452 m. Euro in 2010. In the category health administration and insurance, public expenditure decreased by app. 7.9% between 2009 and 2010.

Current expenditure on health – private

The share of current private health care expenditure (23.8% of total current expenditure on health in 2010) consists of expenditure by private households and private insurance enterprises, private non-profit institutions serving households and expenditure by companies on occupational health care.

Expenditure by private households and private insurance enterprises account for the largest share of current private expenditure on health. Their expenditure relate to in-patient care, out-patient care, pharmaceutical products, medical durables and non-durables, and health administration (private health insurance).

In 2010 private households and private insurance enterprises spent about 28.5% of their total current expenditure on health on in-patient care. The largest expenditure item of private households and private insurance enterprises was with a share of 35% that of pharmaceutical products, medical durables and non-durables

Expenditure by private households and private insurance enterprises on in-patient care includes expenditure on hospitals, including convalescent homes, rehabilitative facilities and nursing and residential care facilities. It amounted to 1.8 bn. Euros in 2010 and represents an increase of 1.9% over the previous year.

Private households and private insurance enterprises spent about 2.2 bn. Euros in 2010 on out-patient care, i.e. medical and dental care, services of non-medical health practitioners, patient transport and emergency rescue and long-term nursing care (home care). This constitutes 35% of their total current expenditure on health care.

In 2010, private households and private insurance enterprises spent 1.9 bn. Euros on pharmaceutical products, medical durables and non-durables; that is 29.9% of their total current expenditure on health care. During the period of 1990 to 2010, this expenditure increased by an annual average rate of 5.3%.

Expenditure by private non-profit institutions serving households amounted to 258 m. Euros in 2010.

Expenditure on occupational health care amounted to 37 million Euros in 2010; this is an increase of 3.5% compared to the previous year.

Investments

Gross fixed capital formation by providers of health care increased between 1990 and 2010 from 768 m. Euros to 1.7 bn. Euros. Of the 1.7 bn. Euros in 2010, 992 m. Euros (59,6%) were public investments. Between 2009 and 2010, investments (public and private) decreased by app. 2.7%. Note that investments for “provincial fund hospitals” are included in public investments by health care provider institutions.

SHA Tables 1, 2, 3 and 4 for 2010

Detailed results from the SHA tables 2, 3 and 4, available for the years 2004 to 2010 and from the SHA table 1, available for the years 2005 to 2010 allow the illustration of current health expenditure (excluding investments) by sources of funding (HF), by functions of health care (HC) and by providers of health care (HP).

In Austria, current health expenditure amounted to 29.8 bn. Euros in 2010. Expenditure by central government, provincial government and local government were 9.6 bn. Euros (32.4%) and 13.3 bn. Euros (44.8%) were spent by social security funds. In total, 77.1% of current health expenditure was financed by public sources.

Private households spent about 5 bn. Euros on goods and services of health care, which constitutes 16.8% of total current expenditure on health care in Austria. Private insurance enterprises financed 4.7%, private non-profit institutions serving households 1.2% and enterprises financed 0.1% of current health expenditure in 2010. In total, 22.9% of current health expenditure was financed by private sources.

In Austria, the largest share of current health expenditure according to „System of Health Accounts“, that is about 11.5 bn. Euros, was spent on services in hospitals (HP.1). That corresponds to 38.8% of total current expenditure on health. Current expenditure on hospitals was financed by central, provincial and local governments with 46.3% and by the social security funds with 44.9%. The remaining 8.8% were financed privately (private insurance enterprises, private households). Of the 11.5 bn. Euros of current expenditure on services provided in hospitals, 85.3% (or 9.8 bn. Euros) were spent on services of in-patient (curative and rehabilitative) care (HC.1.1; HC.2.1), 1.3% on day care services (HC.1.2) and 13.4% on services of out-patient curative care (HC.1.3).

In 2010, 23.7% of current health expenditure, 7.1 bn. Euros respectively, was spent on services by ambulatory health care providers (HP.3). Thereof, 2.7 bn. Euros were allocated to services provided by physicians (HP.3.1) and 1.4 bn. Euros to services by dentists (HP.3.2). The remaining expenditure was spent on services by other health practitioners, services in health care centres (“Ambulanzen”), etc. Services of ambulatory health care providers (HP.3) were with 57.6% (4.1 bn. Euros) mainly financed by social security funds (HF.1.2) and 29.9% (2.1 bn. Euros) by private households (HF.2.3) with. The remaining 12.5% was borne by central, local and provincial governments (HF.1.1), private non-profit institutions serving households (HF.2.4) and private insurance enterprises (HF.2.2).

In 2010, 16.9% of total current expenditure on health were spent on medical goods (HC.5) provided by retail sale and other providers of medical goods (HP.4). Thereof, dispensing chemists (HP.4.1) received 3.7 bn. Euros and all other retail sales (HP.4.2-4.9) received 1.3 bn. Euros. Medical goods provided by retail sale and other providers were financed with 61.4% (3.1 bn. Euros) by social security funds (HF.1.2) and with 36.5% (1.8 bn. Euros) by private households (HF.2.3). General government (excl. social security) and private insurance enterprises contributed 102 m. Euros (2%) to the expenses related to medical goods.  

In 2010, a total of 2.6 bn. Euros was spent on services of convalescent and nursing homes (HP.2). App. 17.4% of this expenditure was spent on in-patient and rehabilitative care (HC.2.1) in convalescent homes. The remaining 82.6% (app. 2.2 bn. Euros) was spent on in-patient long-term nursing care (HC.3.1). Current expenditure on services in convalescent homes and nursing homes was mainly financed by central, local and provincial governments with 1.5 bn. Euros, by social security funds with 231 m. Euros, by private households with 815 m. Euros and by non-profit institutions serving households with 44 m. Euros. The remaining 33 m. Euros were borne by Private insurance enterprises.

Current expenditure on prevention and public health services (HC.6) amounted to 532 m. Euros in 2010. Thereof, central, local and provincial governments (HF.1.1) financed 238 m. Euros or 44.7%. Social security funds (HF.1.2) contributed 214 million Euros (40.2%) to prevention and public health services in 2010.

In 2010, 1.1 bn. Euros were spent on health administration and health insurance (HC.7). 5.3% of which were borne by the government (excluding social security), 55.6% by social security funds and 39.1% by providers of private insurance enterprises.

SHA –Table 7: Personal expenditure on health by age and gender

In addition to SHA-Tables 1, 2, 3 and 4, where current expenditure on health care is depicted by function of health care (HC) and source of funding (HF) and provider industry (HP), current individual expenditure on health (HC.1 to HC.5) is broken down into age groups and gender in SHA-Table 7. SHA-Table 7 shows the results of in-patient services, day-care services, out-patient services, home care, ancillary services to health care and medical goods dispensed to out-patients. Not included in Table 7 are prevention and public health services (HC.6) and health administration and health insurance (HC.7), since these are collective expenses that cannot be allocated to an individual. Basis for the calculation of Table 7 is the SHA-data, whereby current individual expenditure is allocated to age-groups and sexes according to several distributions.

In 2007 a total of 25.2 bn. Euros was spent on personal expenditure on health (HC.1 to HC.5) by age and gender. About 56.5% of the expenditure on health was spent on women and compared to 43.5%, which were spent on men. In general expenditure on health is continuously increasing up to the age group of 65 to 74-old persons and decreasing for the people aged 75 years and older. Expenditure on women aged 75 to 84 years increases, before it starts to decrease for older age groups. This is attributable to the fact that the number of people at the age of 85 or older is little.

Overall, health expenditure on women was the highest for in-patient services in 2007, with 6.1 bn. Euros. This expenditure includes expenditure on hospitals, nursing homes as well as expenditure on convalescence homes. Regarding children aged 1 to 4 years and 5 to 14 years, and the group of working-aged persons between 15 to 44 years, the highest expenditure is on out-patient services. Expenditure on home care services is increasing for senior citizens, aged 75 to 84 years. Considering expenditure on health care for women, the highest costs occur in the group of 45 to 64 year olds and amount to 3.4 bn. Euros.

The distribution of health care expenditure on men is similar: The highest costs incurred by in-patient services (4.9 bn. Euros). Except, children between 1 and 4 years and 5 and 14 years, and the group of working-aged persons between 15 to 44 years, have the highest expenditure on out-patient health care. As in the case of women, the highest costs occur in the group of 45 to 64 year olds and amount to 3.3 bn. Euros.

The main differences between men and women can be observed in the category home care. Expenditure on men, at the cost of 174 m. Euros for the group aged 75 to 84 years and 118 m. Euro for those aged 85 or older is lower than expenditure on women.

Concerning expenditure differences between women and men in the respective age-groups, the largest difference occurs in the group of people aged 85 or more. Only 22.9% of expenditure in this group is attributed to men, whereas 77.1% is attributed to women. In the respective age group there is a wide disparity in demographic terms; the proportion of women compared to men is much larger.

Notes on Health Expenditure in Austria according to the “System of Health Accounts”

The results presented before are compiled according to the “System of Health Accounts” (SHA) which is a system of comprehensive, consistent and internationally comparable health accounts and consists of ten standard tables. The manual entitled “A System of Health Accounts” was first published by the OECD in May 2000 and can be accessed on the OECD-Homepage. In the Meantime OECD, WHO and EUROSTAT have published a new SHA manual in summer 2011.

Statistics Austria annually publishes health statistics by order of the Federal Ministry for Health and reports it to the Organisation for Economic Co-operation and Development (OECD), to the World Health Organisation (WHO) and to the Statistical Office of the European Communities (EUROSTAT).

With the newly developed International Classification for Health Accounts (ICHA), the SHA tables allow the illustration of health expenditure according to sources of funding (HF), providers of health care (HP) and functions of health care (HC).

Calculating health expenditure by means of the methodology of „System of Health Accounts“ allows a comprehensive compilation and illustration of health expenditure. On the one hand the results of health accounts provide a basis for political decisions and on the other hand are an essential input for health analysis. Furthermore the results ensure an international comparability. You can find an international comparison of health expenditure on the OECD-Homepage.