DEXHELPP: Decision Support for Health Policy and Planning

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This report was produced within the FFG founded Comet K-Project DEXHELPP (2014-2018). It
provides an overview and a description of the landscape of health care providers in the Province of
Lower Austria in 2006 and 2007 and is the preparatory work of the mapping of the whole of Austria.
When analysing pathways of health care service utilisation with the GAP-DRG, which includes
pseudonymised personal service utilisation records for the years 2006 and 2007, the information on
service provider types for the respective time and its inclusion or exclusion in the database is of high
relevance. Therefore the main purpose of the mapping exercise was to find out what service
providers existed in 2006 and 2007 and for which of these providers service utilisation records are
included in the GAP-DRG and can be used for analysing pathways of care and accordingly for which
providers no such records are included or not in a usable form. Consequently limitations in the GAPDRG
concerning coverage of populations, service providers and service utilisation records become
apparent. Looking historically backwards for almost 10 years on the existence of service providers in
2006 and 2007 was one of the main challenges of the mapping exercise besides the inconsistencies
found in different sources of data on numbers of service type providers and on descriptors of the
providers (e.g. hospital beds).

In the report we provide as a starting point some basic information on the GAP-DRG and the
population included in it and then continue with demographic and administrative data on the
Province of Lower Austria, which has nearly one fifth of the total population of Austria and thus is the
second largest province (after Vienna). The mapping exercise follows the structure: inpatient care,
day-care in hospitals, ambulatory care with focus on self-employed general practitioners (Ärzte für
Allgemeinmedizin) and specialist doctors (Fachärzte) and pharmacies. In each provider type different
sub-groups are identified and described, e.g. doctors with a contract with the Social Health Insurance
(Kassenärzte) and doctors without such a contract (Wahlärzte). The estimation of the effectiveness of
health care of the different service provider types in ambulatory care used by the Main Association
of Austrian Social Security Institutions (Hauptverband der österreichischen Sozialversicherungsträger)
is described in this report.