Lyla Lindsey
Austria's healthcare system is a complex two-tier system, with publicly funded care available to all residents and EU visitors, and the option to purchase supplementary private health insurance. The system is decentralized, with responsibilities divided between federal and regional levels, and is funded by a mix of general tax revenues, compulsory social health insurance (SHI) contributions, and out-of-pocket payments. The country has a high density of hospitals and physicians, with a focus on inpatient care, and patients have unrestricted access to most forms of medical care.
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What You'll Learn
Mandatory health insurance
Health insurance is mandatory in Austria, and coverage is very high. In 2019, 99.9% of the population was covered through SHI funds, and this number increased to over 99% in 2023.
Austria's health care system is two-tiered, with virtually all individuals receiving publicly funded care. However, they also have the option to purchase supplementary private health insurance, which can include more flexible visiting hours, private rooms, and doctors. Some individuals choose to pay for their care entirely out-of-pocket. Healthcare in Austria is universal for residents and those from other EU countries. Students from an EU/EEA country or Switzerland with national health insurance in their home country can use the European Health Insurance Card. Self-insured students must pay an insurance fee of €52.68 per month.
Enrollment in the public healthcare system is generally automatic and linked to employment. Once employed, individuals are automatically registered for healthcare and are included in the insurance fund known as Krankenkasse. Insurance protection extends to school and university students, as well as pensioners. Insurance contributions are calculated based on a person's income, and employers are responsible for deducting these contributions and registering their employees with the relevant social insurance office. Employees receive a social insurance number and an e-card, which serves as proof of insurance coverage and must be presented when visiting a doctor.
Austria has a relatively high density of hospitals and physicians. In 2011, there were 4.7 physicians per 1000 people, slightly above the European average. In-patient care is emphasized within the Austrian healthcare system, with the country having the most acute care discharges per 100 inhabitants in Europe. The average hospital stay is 6.6 days, compared to an EU average of 6 days.
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High healthcare expenditure
Austria has a complex, two-tier healthcare system, with mandatory health insurance and high coverage. In 2023, over 99% of the population was covered through social health insurance (SHI) funds. The SHI funds are responsible for ambulatory and rehabilitative care outside hospitals and outpatient medicines, and they negotiate contracts with providers. The federal government is responsible for the legislative framework, including the regulation of SHI, while the states (Länder) regulate hospital care within their jurisdictions.
Healthcare expenditure in Austria is among the highest in the EU. In 2021, per capita health expenditure was US$7272, and in 2019, it was US$6134. In 2013, healthcare expenditure in Austria was 11.0% of GDP, above the EU average of 7.8%. In 2019, public spending on health accounted for 75% of total spending, while out-of-pocket spending was nearly 18%, above the EU average of 15%. Out-of-pocket payments are mainly related to direct spending on outpatient medical care, pharmaceuticals, long-term care, and dental care.
Austria has a relatively high density of hospitals and physicians. In 2011, there were 4.7 physicians per 1000 people, slightly above the European average. In-patient care is emphasised within the Austrian healthcare system, with the most acute care discharges per 100 inhabitants in Europe and an average hospital stay of 6.6 days.
Reforms in recent years have aimed to reduce fragmentation in the health system and improve efficiency. The 18 previously existing SHI funds were merged into three, and a new primary care approach was developed, promoting the establishment of multidisciplinary primary healthcare units. Other reforms include improvements in working conditions, training, and remuneration for health professionals, carers, and care recipients. The comprehensive healthcare reform package for 2024-2028 also includes the expansion of digitalisation in healthcare, such as tele-consultations.
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Public and out-of-pocket spending
Austria's healthcare system is complex, with a mix of public and private funding. Health insurance is mandatory, and coverage is high, with 99% of the population covered through social health insurance (SHI) funds in 2023. The SHI funds are managed by the Main Association of Austrian Social Security Institutions (HVB), which allocates contributions to healthcare providers.
Public spending on health in Austria accounted for 78% of total health expenditure in 2021, which is slightly above the EU average of 80%. Income-related SHI contributions make up about 60% of publicly financed health expenditures, while the remaining 40% comes from general taxation. The federal government regulates SHI and has overall responsibility for the legislative framework, while the states (Länder) regulate hospital care within their jurisdictions.
Out-of-pocket spending on healthcare in Austria was nearly 16% of total health expenditure in 2021, which is above the EU average of 15%. This figure was as high as 28% in 2008 during the economic crisis. Out-of-pocket payments are mainly related to direct spending on pharmaceuticals, outpatient medical care, long-term care, and dental care. Some individuals choose to pay for their care entirely privately, and those with private supplementary insurance may be offered shorter waiting times for certain procedures.
Austria's healthcare system is universal, providing publicly funded care to all residents, including those from other EU countries. Healthcare began to be established as a right with the 1956 General Social Insurance Law (ASVG), which created the insurance fund Krankenkasse. Under this system, individuals become eligible for healthcare upon employment and receive an insurance card that covers healthcare, pensions, and unemployment benefits.
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Health system governance
Austria's health system is complex, with responsibilities for health system governance divided between the federal and regional levels. Health insurance is mandatory, with a coverage rate of over 99% in 2023, and Austrians benefit from a generous benefits package.
Austria's health system has been shaped by the federal structure of the state and a tradition of delegating responsibilities to self-governing stakeholders. This enables decentralized planning and governance, adjusted to local norms and preferences. However, it also leads to fragmentation of responsibilities and inadequate coordination. As a result, reforms have focused on reducing fragmentation by promoting joint planning, decision-making, and financing, mainly through Target-Based Governance Agreements.
The Austrian health system provides universal coverage for a wide range of benefits and high-quality care. There is free choice of providers and unrestricted access to all care levels, including general practitioners, specialist physicians, and hospitals. Health expenditure in Austria is among the highest in the EU, with spending from public sources accounting for 78% of the total in 2021, while out-of-pocket spending accounted for nearly 16%. Out-of-pocket payments are mainly related to pharmaceuticals, outpatient medical care, long-term care, and dental care.
Recent reforms have focused on developing a new primary care approach, promoting the establishment and expansion of multidisciplinary primary healthcare units. There have also been major developments in community nursing and long-term care, targeting improvements in working conditions, training, and remuneration for health professionals, carers, and care recipients. The comprehensive healthcare reform package for 2024-2028 includes plans to expand digitalization in healthcare, making it a primary entry point into the health system through teleconsultations.
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Primary care approach
The Austrian healthcare system is complex, with responsibilities for health system governance divided between federal and regional authorities. Health insurance is mandatory, with 99.9% of the population covered in 2019, and 99% in 2023. This insurance provides Austrians with a generous benefits package.
Austria has a high number of physicians per capita, with 4.8 physicians per 1000 people (compared to the OECD average of 3.1). However, the number of nurses is lower, at 7.7 per 1000 people (OECD average 8.7). The country also has a high number of curative care beds, with 5.5 per 1000 people (OECD average 3.4).
Austria's healthcare system is characterised by free and uncontrolled access to all levels of care. This has resulted in high utilisation of healthcare services, particularly specialist physicians and hospitals. The country's primary care sector is weak compared to other countries with similar socioeconomic conditions, especially in terms of continuity and coordination of care.
To address these issues, Austria has been developing a new primary care approach. This includes the establishment and expansion of multidisciplinary primary healthcare units. Reforms have also aimed to reduce fragmentation in the healthcare system by promoting joint planning, decision-making, and financing.
The Austrian healthcare system has undergone other important reforms in recent years. These include merging the previously existing SHI funds into a smaller number to reduce fragmentation and improve efficiency. There has also been a large nursing and long-term care reform targeting improvements in working conditions, training, and remuneration for health professionals, carers, and care recipients.
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Frequently asked questions
The Austrian healthcare system is complex, with a two-tier system in which individuals receive publicly-funded care, but can also purchase supplementary private health insurance. Healthcare in Austria is universal for residents and those from other EU countries.
The Austrian healthcare system is funded by a mix of general tax revenues, compulsory social health insurance (SHI) contributions, and out-of-pocket spending. Income-related SHI contributions account for about 60% of publicly financed health expenditures, while the remaining 40% comes from general taxation. Out-of-pocket spending is mainly related to direct payments for outpatient medical care, pharmaceuticals, long-term care, and dental care.
The Austrian healthcare system provides relatively unrestricted access to all levels of care, including general practitioners, specialists, and hospitals. There is no formal gatekeeping system in place. The system also covers ambulatory and rehabilitative care outside hospitals and outpatient medicines.
Recent reforms in the Austrian healthcare system have focused on reducing fragmentation and promoting joint planning, decision-making, and financing. Other reforms include the development of a new primary care approach, improvements in nursing and long-term care, and the expansion of digitalization in healthcare.
