Mr and Mrs Austria visit specialists, outpatient clinics and hospitals particularly often when compared with the rest of Europe. However, health and life expectation do not profit from this accordingly. Kathryn Hoffmann, a public health expert at the MedUni Vienna, therefore recommends a re-evaluation of the general practitioner.
"The use of the Austrian health system is very high and uncoordinated in comparison with other EU countries," explains Kathryn Hoffmann from the Department of General and Family Medicine at the Centre for Public Health at the MedUni Vienna. This is, however, not reflected in better health or a higher "life expectation in good health". For example, Austria lies under the EU 27-average with regard to "life expectation in good health" from 65 years onwards. On the other hand, the countless visits to specialists and outpatient clinics lead to above average costs.
According to Hoffman this would be rectified by general practitioners performing an obligatory coordinating function as numerous examples from other EU countries with better results demonstrate. Says Hoffmann: "General practitioners could, for instance, help their patients navigate the ever more complex health system and thus avoid multiple, unnecessary and stressful investigations and treatments."
According to a study led by Hoffmann, which was published this year in the leading journal, the European Journal of Public Health, the percentage of Austrians, who visit consultants in outpatient clinics at least once a year, lies at 67.4%. However, in countries such as Norway (17%), Ireland (24.8%) or the Netherlands (12.8%) the percentage is clearly much lower.
The possibility of visiting a specialist directly without a prior consultation with and referral from a general practitioner is also used intensively: almost every sixth person who visits a specialist at least once a year, every eleventh person who visits an outpatients' clinic and every twelfth person who had a hospital stay, did not consult a general practitioner in the same period.
The authors of the study see the cause of this in a lack of coordination in the Austrian health system. They think this could even have negative consequences for patients. Says Hoffmann: "For example, relevant health problems could be overlooked if the diagnostics are only being carried out in one particular direction and the overview of the individuals concerned is lost." Furthermore, a lack of coordination often results in unnecessary investigations that take it out of people and are even risky, or in prescriptions for medications which are not optimally adjusted for each other.
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"Access points to the different levels of health care and demographic predictors in a country without a gatekeeping system. Results of a cross-sectional study from Austria." Hoffmann K, Stein KV, Maier M, Rieder A, Dorner TE. Eur J Public Health. 2013 Jan 31.