!!!Krankenhäuser

Hospitals, according to the law on hospitals (Krankenanstaltengesetz) 
hospitals are institutions staffed and equipped for the diagnosis and 
surveillance of the physical well-being of people by way of 
examinations, for the performance of operations, for the prevention, 
improvement and cure of diseases by way of treatment, for childbirth 
and artificial fertilisation. Hospitals treat in-patients and 
out-patients.

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General hospitals are intended to serve all people without regard to 
sex, age or form of medical treatment. In terms of services rendered 3 
types of hospitals are distinguished: general hospitals providing 
basic medical care for an area with about 50,000 to 90,000 
inhabitants, special hospitals for special medical care for about 
250,000 and 300,000 inhabitants and central hospitals, which are 
equipped according to the latest medical knowledge. University 
hospitals are always central hospitals.

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Specialised health and medical care facilities are designed for a 
certain group of people, for certain diseases (e.g. lung diseases), 
certain age groups (e.g. hospitals for children) and certain purposes 
(e.g. military hospitals) Public hospitals must be open to the public 
and are non-profit making. Private hospitals can be profit-making or 
non-profit making.

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The largest hospitals in Austria are: the Vienna General Hospital 
(AKH, with university centre, 2,055 beds), the Landeskrankenhaus 
(Provincial Hospital) in Graz (with university centre, 1,988 beds), 
the Landeskrankenhaus Klagenfurt (1,733 beds), the Landeskrankenhaus 
Innsbruck (with university centre, 1,485 beds) and the 
Landeskrankenhaus Salzburg (1,282 beds).

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''Historical background:'' In early Christianity a "hospital" was an 
accommodation for travellers, which later became a religious and 
social institution of the church. In the Middle Ages monastic orders 
(Cistercians), orders of knighthood (Knights Hospitallers of the Order 
of St. John) and reformed orders were dedicated to medical care. 
Hospitals resembled churches (they had a large hall with niches for 
the beds and an altar at the eastern side). In the towns "citizens' 
hospitals" were founded as institutions for the poor. In the High 
Middle Ages isolated institutions were established for people with 
infectious diseases (leprosy, plague) on the outskirts of towns. Since 
the middle of the 16%%sup th/%  century the order of the  Brothers 
Hospitallers has been dedicated to hospital work; hospital were given 
their own surgeons and trained medical staff. The Vienna General 
Hospital was opened under the reign of Joseph II in 1784; this 
meant a final separation of almshouses from hospitals. From the middle 
of the 19%%sup th/%  century onwards hospitals were founded in most 
district capitals, based on the imperial sanitary laws. During the 
2%%sup nd/%  half of the 20%%sup th/%  century, most hospitals have 
been extensively enlarged and modernised.

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The provinces of Austria have the duty to guarantee medical service in 
hospitals by operating public hospitals or by agreements with carriers 
of other hospitals.

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''Hospital financing:'' Hospitals have a permanent income from 
standard daily charges (paid by the social insurance agency per 
patient-day; these charges differ from province to province and in 
1995 already covered less than 40% of the cost of hospital 
accommodation and treatment), hospital accommodation and treatment 
charges, special charges (for higher categories, mostly paid by 
private insurance agencies), and contributions made by the patients. 
For out-patient treatment hospitals receive out-patient benefits.

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As the income does not cover costs, until 1996 losses were compensated 
by the  Krankenanstaltenzusammenarbeitsfonds, the provinces, 
municipalities, legal entities and hospital catchment areas delineated 
by the provinces and required to pay contributions. A system of 
performance-related hospital financing (LKF) came into force in 1997. 
Provincial hospital finance funds, drawing on resources provided by 
the federal government, the provinces, the municipalities and social 
insurance institutions, were set up to implement the system. The 
services rendered by the hospitals are paid according to a points 
system. Pending further notice the LKF system is valid until December 
31, 2000. University centres in hospitals are paid for teaching and 
research.

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''Teaching and training in hospitals:'' General practitioners are 
required to pass at least 3 years of training in a hospital. For 
medical specialists on-the-job training in hospitals lasts several 
years. Medical staff with a diploma, midwives, various kinds of 
medical technologists and nursing staff can only be trained in a 
hospital. Hospitals also provide further education and special 
training for medical staff.

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In 1996 2,271,660 patients were treated in Austrian hospitals, 
totalling 21,351,162 patient-days. Whereas from 1970 to 1996 the 
hospitalisation rate increased from 132 to 249 (patients per 1,000 
people), the average duration of hospitalisation fell from 17 to 9.6 
days.

!Literature
Gesundheitswesen in Oesterreich, ed. by Verband der 
Versicherungsunternehmungen Oesterreichs; H. Ingruber, 
Krankenhausbetriebslehre, 1994; M. Binder, in: T. Tomandl, System des 
oesterreichischen Sozialversicherungsrechts, 1994; Federal Ministry 
for Labour, Health and Social Affairs, Das Gesundheitswesen in 
Oesterreich, %%sup 2/%1998.


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