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Inequalities and Multiple Discrimination in Access to Healthcare in Austria

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Inequalities and Multiple Discrimination in Access to Healthcare in Austria Background Report Inequalities and Multiple Discrimination in Access to Healthcare in Austria May 2014 Albert Kraler (ed.), Julia Edthofer, Edith Enzenhofer, Bernhard Perchinig INEQUALITIES AND MULTIPLE DISCRIMINATION IN ACCESS TO HEALTH CARE IN AUSTRIA BACKGROUND REPORT Albert Kraler (ed.) Julia Edthofer, Edith Enzenhofer, Bernhard Perchinig, International Centre for Migration Policy Development (ICMPD), Research Institute of the Red Cross May 2014 Inequalities and Multiple Discrimination in Access to Health in Austria Disclaimer This document was commissioned as background material for the comparative report on ‘Inequalities and multiple discrimination in access to and quality of healthcare’ published by the European Union Agency for Fundamental Rights (FRA). The views expressed in this document do not necessarily reflect the views or the official position of the FRA. The document is made publicly available for information purposes only and does not constitute legal advice or legal opinion. The research for this project was carried out between December 2009 and November 2011. The report was last edited in November 2011 and released in May 2014. International Centre for Migration Policy Development (ICMPD) Gonzagagasse 1 A-1010 Vienna Austria www.icmpd.org International Centre for Migration Policy Development , May 2014 All rights reserved. No part of this publication may be reproduced, copied or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without permission of the copyright owners. The contents of this publication is the sole responsibility of ICMPD. 1 Inequalities and Multiple Discrimination in Access to Health in Austria Table of Contents 1. Introduction ..................................................................................................................................... 5 Part I – General Policies on Health ....................................................................................................... 7 2. Health System .................................................................................................................................. 7 2.1. Overall tenets of the health care system .................................................................................... 7 2.1.1.Evolution of the health care system ................................................................................. 7 2.1.2.Statutory and private health insurance............................................................................. 9 2.1.3.Different treatment standards and quality control .......................................................... 12 2.2. Institutional structure ................................................................................................................ 13 2.3. Provision of services ................................................................................................................ 15 2.3.1. Medical practitioners in private practice ........................................................................ 15 2.3.2. The hospital sector ........................................................................................................ 16 2.3.3. Other relevant actors ..................................................................................................... 16 3. Health entitlements ....................................................................................................................... 17 3.1. General description .................................................................................................................. 17 3.2. Cost sharing ............................................................................................................................. 19 3.3. Preventive health schemes ...................................................................................................... 20 3.3.1. Mother-child-card and reproductive medicine ............................................................... 21 3.4. Mental Health Care .................................................................................................................. 22 3.5. Long term and rehabilitative care ............................................................................................. 24 4. Specific health policies targeting vulnerable groups................................................................ 32 4.1. General policies targeting vulnerable groups ........................................................................... 32 4.2. Policies targeting immigrants ................................................................................................... 33 4.2.1. Responding to cultural diversity .................................................................................... 33 4.2.2. Initiatives targeting non-insured and other vulnerable migrants ................................... 36 4.3. Policies regarding disabled persons ........................................................................................ 37 5. General description of discrimination legislation ..................................................................... 40 5.1. Constitutional regulations ......................................................................................................... 40 5.2. The antidiscrimination legal framework ................................................................................... 41 5.3. Grounds of discrimination covered .......................................................................................... 48 5.3.1. Definitions of race, age, and disability........................................................................... 51 5.3.2. Material scope ............................................................................................................... 53 5.3.3. Types of discrimination covered, multiple discrimination .............................................. 53 6. International Law ........................................................................................................................... 67 6.1 International instruments signed and ratified .......................................................................... 67 6.2 Relevant case law ................................................................................................................... 69 7. Review of direct and indirect discrimination in healthcare ...................................................... 70 8. Review of complaints’ mechanism in place in the health sector ............................................. 71 8.1. Complaints mechanisms in place ............................................................................................. 71 8.2. Areas of complaints .................................................................................................................. 73 8.3. Accessibility of complaints mechanism .................................................................................... 74 2 Inequalities and Multiple Discrimination in Access to Health in Austria 8.4. Satisfaction with the handling of complaints ............................................................................ 75 8.5. Evaluation mechanisms ........................................................................................................... 75 Part III – Review of Evidence of Inequality and Discrimination in Access to Health .................... 77 9. Availability of Data and Reporting ............................................................................................... 77 9.1. Data on Health.......................................................................................................................... 77 9.2. Data on Access ........................................................................................................................ 81 9.3. Health Reporting....................................................................................................................... 84 10. Demographics, Migration, and Diversity .................................................................................... 93 11. Inequalities in Health Status ........................................................................................................ 94 11.1. Life Expectancy and Mortality ................................................................................................ 94 11.2. Fertility Rates and Infant Mortality .......................................................................................... 95 11.3. General Health Condition (Self Assessment) ......................................................................... 96 11.4. Morbidity and Specific Health Conditions ............................................................................... 98 11.4.1. Cardiovascular and Circulatory Diseases ................................................................... 98 11.4.2. Diseases of the Musculoskeletal System and Connective Tissue .............................. 99 11.4.3. Tumours and Cancer ................................................................................................ 101 11.4.4. Diabetes .................................................................................................................... 102 11.4.5. Disability .................................................................................................................... 103 11.4.6. Mental Health ...........................................................................................................
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