Directory of European Resources > Eurocleft Clinical Network > Registered Clinical Teams > Austria

Clinical Teams in AUSTRIA

• Graz
• Innsbruck (University Department of Maxillofacial Surgery)
• Innsbruck (University Department of Plastic Surgery)
• Klagenfurt
• Linz
• Salzberg
• Vienna
• Wels

Population
Approximately 8.1 million.

Health Service
In 1997 a fundamental health care reform process started with the aim of containing costs without surrendering the commitment to equal access for all. The core of the reform is the Austrian Health Care Plan and the introduction of a performance related hospital financing system. Primary care is provided to a large extent, by physicians in private practice, most of whom are under contract with the health insurance agencies.

Hospitals are financed jointly by the owners and from public sources, the social insurance system being compulsory and providing health cover for nearly all employed and unemployed persons, pensioners and their family members. There are different schemes of health insurance for different employment groups but in general the access to health services for insured persons is free. Patients admitted to hospitals have to pay an index linked daily charge of maximum $7. About 40% of the population have supplementary private health insurance.

The Federal authorities are working out a Quality Assurance Programme containing measures for quality standards. Quality strategies are already being tested in a number of hospitals.

Cleft Care Organisation
Austria sees approximately 130* new born babies with clefts of the lip and/or palate annually. However, additional patients with clefts from the neighbouring countries of Bavaria and Southern Tyrol are also treated in Austria, under a special agreement. Care is provided by at least six relatively small centres dispersed throughout the country. Some care is also delivered by individual clinicians. Each of the main centres has its own orthodontic department in the associated dental hospital.

Challenges to Attaining the Eurocleft Consensus Recommendations
Surgical protocols vary throughout the centres with primary operations mainly being performed by maxillofacial surgeons. However plastic surgeons also deliver cleft care. Rivalries between centres and surgical disciplines are evident. There is no special financial support from government for cleft centres, all primary operations are free but patients pay a large part of the costs for orthodontic treatment themselves. There is no official organisation for parents but there are some self help associations for parents. There is currently little evidence of intercentre collaboration. As yet there has been no Austrian participation in intercentre comparisons and clinical trials.

In the year 2000 the Austrian Cleft Palate and Craniofacial Association was established with collaboration between colleagues from the disciplines of maxillofacial surgery, orthodontics, ENT, speech therapy, phoniatrics/audiology and genetics. Its intentions are to co-ordinate and improve cleft care in Austria, to organise every two years a scientific meeting and to introduce an agreed documentation system for all cleft centres and in the future to participate in intercentre comparison studies.

Future Plans
The desirability of centralisation in fewer centres is acknowledged but no mechanisms for achieving this have yet emerged.

* Estimated number of clefts per annum from calculations using World Fact Book figures of 8.1 million population, birth rate of 9.62 per 1,000 population and assuming incidence of clefting at 1:600