2. Ensuring sufficient physical infrastructure and workforce capacity
ENSURING SUFFICIENT PHYSICAL INFRASTRUCTURE AND WORKFORCE CAPACITY is crucial for dealing with the COVID-19 outbreak, as there may be both a surge in demand and a decreased availability of health workers. The section considers the physical infrastructure available in a country and where there are shortages, it describes any measures being implemented or planned to address them. It also considers the health workforce, including what countries are doing to maintain or enhance capacity, the responsibilities and skill-mix of the workforce, and any initiatives to train or otherwise support health workers.
2.1 Physical infrastructure
Austria has a strong inpatient sector. Over the last few decades, the country has spent more on inpatient care compared to most other countries and has among the highest numbers of physicians and hospital beds per population. In 2017, there were 5.5 acute care beds per 1,000 inhabitants (compared to the OECD33 average of 3.7 beds per 1,000 inhabitants). Bed occupancy rates were about 74% in 2017, slightly below the OECD33 average of 75%. In regard to ICU beds, Austria also displays high capacity with 28.9 ICU beds per 100,000 inhabitants in 2017 (OECD10: 15.9 per 100,000 inhabitants).
As part of the crisis response mechanisms the state governments report their hospital capacities (hospital beds, ICU beds and ventilators) to the crisis management team at federal level. These feed into prognosis tools for COVID-19 cases and hospitalisation rates. There are around 45,000 acute care hospital beds in Austria, of which about 50% were made available for COVID-19 patients with moderate course of disease. In addition, another several thousand hospital beds could be made available from facilities other than hospitals, such as rehabilitation facilities (ca. 7,500 additional beds, plus 1,735 regular beds made available on April 8, 2020). Furthermore, there are more than 2,000 ICU beds (excl. beds for critical infant treatment), of which around 1,000 are currently available for COVID-19 treatment. Out of nearly 2,900 ventilators in Austria, around 1,500 are available for COVID-19 patients.
Availability and distribution of physical resources are, in general, analysed in the Regional Structural Plans for Healthcare, which also provide information on potential shortages. However, these plans are not provided electronically and thus are not available on a day-to-day basis. In general, information on medical equipment or protective equipment is not administered in a central database at federal level. However, the Ministry of Health has started a regular survey to obtain an overview of these resources and has included the results in its national database.
At the beginning of March, masks and protective equipment were stuck at the German border due to an export ban. By mid-March, the situation was resolved at EU level.In March, the Ministry of Health started to purchase critical equipment in national and international markets and distributed it throughout the country.
In Austria, as in many other countries, even before the COVID-19 crisis, shortages of medicines had increasingly become a problem. Austria has new legislation to mitigate these risks of shortages. While it is not directly related to COVID-19, the legislation may help address shortages also during this crisis. This legal order has become valid on April 1, 2020 (but its legal preparation process dates back to autumn). Its key content includes the obligation for marketing authorisation holders to report shortages of prescription-only medicines to the Medicines’ Agency (previously reporting was done on a voluntary basis), and the possibility for the Medicines’ Agency to issue an export ban for medicines in the registry on shortages.
https://www.kleinezeitung.at/international/corona/5781351/Deutschland-blockiert_Lkw-mit-Schutzmasken-steckt-an-der-Grenze-fest (media report from 8th March, accessed on 3rd April 2020)
https://www.spiegel.de/wirtschaft/soziales/coronavirus-bundesregierung-hebt-eu-exportverbot-fuer-schutzkleidung-auf-a-da32256c-bf75-421b-89d9-3bb6820e4dda (media report from 19th March, accessed on 3rd April 2020)
Legislation (in German): “Verordnung des Bundesministers für Soziales, Gesundheit, Pflege und Konsumentenschutz über die Sicherstellung der Arzneimittelversorgung“ (BGBl. II Nr. 30/2020, accessible at: https://www.ris.bka.gv.at/eli/bgbl/II/2020/30).