Health Expenditure in Austria

Current expenditure on health – public

The current expenditure on health of general government (central government, provincial government, local government and social security funds) amounted in 2009 to 22.6 billion Euros. The current expenditure on health plus public investments is 23.5 billion Euros, which results in 77.7% of the total health expenditure.

The amount of 22.6 billion Euros can be split as follows. Around 46.8% of the current public expenditure was spent on in-patient care, 24.5% for out-patient care, 8.7% for long-term nursing care and 13.9% for pharmaceutical products, medical durables and non-durables. 1.3% of public current expenditure on health was spent on patient transport and emergency rescue, 1.9% for prevention and public services and 2.9% for general health administration and insurance. Current public spending on health increased in 2009 by 3.6% against the year before.

Public expenditure for in-patient care increased from 3.5 billion Euros in 1990 to 10.6 billion Euros in 2009. On average, public expenditure for in-patient care annually increased by 5.9%. The expenditure on inpatient care increased by 4.8% from the year 2008 to 2009. Public expenditure on out-patient care in 2009 amounted to 5.5 billion Euros. Between 2008 and 2009, public current expenditure for out-patient care increased by 4.4%; during the period 1990 to 2009 by an annual average of 5%. In 2009, public current expenditure for long-term nursing care amounted to 1.96 billion Euros. In comparison to the last year this category grew by 8.5%. Between 2008 and 2009 public current expenditure on pharmaceutical products, medical durables and non-durables decreased by 3% to 3.1 billion Euros. The expenditure on prevention decreased by 1.5% and the expenditure on health administration and insurance decreased by 1% from the year 2008 to 2009.

Current expenditure on health – private

Private health spending (22.3% of total health expenditure in 2009) includes expenditure by private households and private insurance enterprises, private non-profit institutions serving households and expenditure for occupational health care.

Expenditure by private households and private insurance enterprises account for the largest share of current private health expenditure. These items, in turn, are made up of expenditure for in-patient care, out-patient care, pharmaceutical products, medical durables and non-durables, and health administration (private health insurance).

In 2009 private household and private insurance enterprises spent around 29% of their current expenditure on health for in-patient care.

The largest expenditure item of private households and private insurance enterprises was that for pharmaceutical products, medical durables and non-durables with 32.7%.

Expenditure by private households and private insurance enterprises for in-patient care includes expenditure on hospitals, including convalescent homes, rehabilitative facilities and nursing and residential care facilities, and amounted to 1.7 billion Euros in 2009. This figure represents an increase of 1% over the previous year.

Private households and private insurance enterprises spent around 1.8 billion Euros in 2009 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 is 31.7% of their total current expenditure on health care.

In 2009, private households and private insurance enterprises spent 1.9 billion Euros for pharmaceutical products, medical durables and non-durables; that is 32.7% of their total current expenditure on health care. During the period 1990 to 2009, these expenditure by private households and private insurance enterprises increased by an annual average of 5.4%.

Expenditure by private non-profit institutions serving households amounted to 239 million Euros in 2009.

Expenditure for occupational health care amounted to 36 million Euros in 2009, this is an increase of 3.5% over the previous year.

Investments

Gross fixed capital formation by providers of health care increased between 1990 and 2009 from 720 million Euros to 1.7 billion Euros. Of the 1.5 billion Euros in 2009, 945 million Euros (55%) were public investments. Between 2008 and 2009, investments (public and private) have increased by 8%. Note that the investments for “provincial fund hospitals” are included in public investments of health care provider institutions.

SHA Tables 1, 2, 3 and 4 for 2008

Detailed results from the SHA tables 2, 3 and 4 available for the years 2004 to 2008 and from the SHA table 1 for the years 2006 to 2008 allow the illustration of current health expenditure (without 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 27.7 billion Euros in 2008. The expenditures of central government, provincial government and local government were 8.8 billion Euros (31.8%) and 13 billion Euros (46.8%) were spent by the social security funds. In total, 78.6% of current health expenditure was financed publicly.

Private households spent 4.3 billion Euros on goods and services of health care, which is 15.5% of total current health expenditure in Austria. Private insurance enterprises financed 4.8%, private non-profit institutions serving households 1% and enterprises financed 0.1% of current health expenditure in 2008. In total, 21.4% of current health expenditure in Austria was financed privately.

In Austria, the largest part of current health expenditure according to „System of Health Accounts“, that is around 10.9 billion Euros, was spent for services in hospitals (HP.1). That corresponds to 39.4% of total current health expenditure. Current expenditure on hospitals was financed by central, provincial and local governments with 44.7% and by the social security funds with 46.1%. The remaining 9.2% were financed privately (private insurance enterprises, private households). Out of 10.9 billion Euros of current expenditure on services provided in hospitals, 86.1% (or 9.4 billion Euros) were spent on in-patient (curative and rehabilitative) care (HC.1.1; HC.2.1), 1.3% on day care (HC.1.2) and 12.6% on out-patient curative care (HC.1.3).

In 2008, 23.4% of current health expenditure and accordingly 6.5 billion Euros were spent on services by ambulatory health care providers (HP.3). Thereof, 2.6 billion Euros were allocated to services provided by physicians (HP.3.1) and 1.3 billion 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 financed by the social security funds (HF.1.2) with 62.2% (4billion Euros) and by private households (HF.2.3) with 25.5% (1.7 million Euros). The remaining 12.2% 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 2008, 18.2% of total current expenditure was spent for medical goods (HC.5) purchased from retail sale and other providers of other medical goods (HP.4). Thereof, 3.8 billion Euros went to dispensing chemists (HP.4.1) and 1.2 billion Euros to all other retail sales (HP.4.2-4.9).  Medical goods provided by retail sale and other providers were financed by 62.8% by the social security funds (HF.1.2) and by 34.8% by private households (HF.2.3) with 1.7 billion Euros. The general government (excl. social security) and private insurance enterprises contributed 119 million Euros (2.4%).  

In 2008, a total of 2.2 billion Euros was spent on total current expenditure for services in convalescent homes and nursing homes (HP.2). Approximately 17.2% of this expenditure item was spent on in-patient and rehabilitative care (HC.2.1) in convalescent homes. The remaining 82.8% (approximately 1.8 billion Euros) were spent for in-patient long-term nursing care (HC.3.1). Current expenditure for services in convalescent homes and nursing homes were financed by central, local and provincial governments with 1.3 billion Euros, by the social security funds with 164 million Euros, by private households with 643 million Euros and by non-profit institutions serving households (36 million Euros) and private insurance enterprises (30 million Euros). 

Current expenditure for prevention and public health services amounted to 517 million Euros in 2008. Thereof, 212 million Euros or 41% were financed by central, local and provincial governments (HF.1.1). The social security funds (HF.1.2) contributed 233 million Euros (45%) to prevention and public health services in 2008.

In 2008, 1 billion Euros were spent on health administration and health insurance (HC.7). Of that total, 6.2% can be allocated to providers of the government (excluding social security) for general health administration and insurance (HP.6.1), 58% to providers of general health administration and insurance of the social security funds (HP.6.2) and 35.8% to providers of private insurance enterprises.

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

SHA-Table 7 shows current expenditure on health by age groups and gender for the year 2006. Personal health care estimates by function of health care (HC) and source of funding (HF) are broken out in age groups and gender. 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 are health care by function for prevention and public health services (HC.6) and Health administration and health insurance (HC.7).

In 2006 a total of 23.6 billion Euros was spent for the personal expenditure on health by age and gender. About 57% of the expenditure on health was spent on women and 43% on men. In general the expenditure on health are increasing until the age group of 65 to 74-old persons and decreasing for the 75 and older population.

Health expenditure for women has the highest results for in-patient services expenditure (5.8 billion Euros). This expenditure includes health expenditure for hospitals, nursing homes and convalescence homes.  But children from 1 to 4 and 5 to 14-years, and the age-group for working-age person from 15 to 44-years have the highest expenditure for health for out-patient services. Expenditure for home care services are increasing for seniors, 75 to 84 years.

Health expenditure for men is similar: The highest results belong to in-patient services (4.6 billion Euros). Except children from 1 to 4 and 5 to 14-years, and the age-group for working-age person from 15 to 44-years, they have the highest expenditure for out-patient health expenditure.

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.

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.