National News

Population Growth – A Challenge

Latest News from the Association of Hospital Managers of Vienna

Population growth and the consequent challenges for the healthcare sector was the aptly chosen theme of the Seventh Training Conference for Hospital Managers held in Vienna in November 2008.

The proportion of the population aged 65 years and over is increasing worldwide. Accounting for only 5% of the population in 1950 and 7% in 2000, the number of people in this age group is expected to rise to 1.5 billion or 17% of the global population by 2050, with Europe and Japan expected to be disproportionately affected. While this trend is ostensibly positive, the ageing of the population raises questions for society in general, for instance, in employment, and health systems in particular. Another issue arising from demographic change is the increasing proportion of migrants in the population, some of whom come from alien cultures. While the phenomenon is common to all European countries, in Austria it is most marked in Vienna.

The Congress Organiser

The Association of Hospital Managers of Vienna, also known by its old-fashioned title, the Working Group of Administrators of Health and Welfare Institutions of Vienna, was founded in 1956 (1). It is a member of the Federal Conference of Austrian Hospital Managers or BUKO as it is commonly known (2). The Vienna Hospital Management Congress has been held biennially since 1996 when it was first organised to mark the 40th anniversary of the founding of BUKO (3). The 2008 Congress took an in-depth look at population growth in a series of presentations and workshops.

The Future of Healthcare in the “Silver” Society

This was the title of a powerful opening address given by Jeanette Huber of the Future Institute (Zukunftsinstitut GmbH in Germany). Ms Huber mapped out several so-called megatrends of the future, including the healthcare revolution and the “silver” revolution. As people live longer and more active lives than their forefathers, the number of older people in the workplace increases. Although this group takes personal responsibility for its health and well-being and values individuality much more than earlier generations, it is important to acknowledge the drawbacks of an ageing population. For example, the incidence of degenerative neurological diseases such as Alzheimer’s is on the increase. In light of rising public and private pro capita expenditure on health in virtually every country in the world, the ageing of the population clearly poses a major challenge for all healthcare systems.

The second presentation was given by Kurt Wagner from Vienna City Council. Mr. Wagner tackled the challenge of demographic change head on and highlighted many of the specific problems facing the Austrian capital. Securing sufficient funds to provide health services, a problem familiar to hospital managers, was another key part of his contribution.

Other presentations addressed a range of issues, including cooperation between providers of nursing home care and the hospital sector, in other words, the transition from illness to needing care. One contribution focused on how we should define optimum patient care. Does it mean providing all possible aspects of care or only those which are needed? The medical challenges arising from increased life expectancy were also discussed.

Another presentation - Older Staff: Head - ache or Treasure Trove? – dealt with an important topic which is often overlooked in debates on demographic trends. The issue of diversity was scrutinised in a presentation which used as an example the migrant community in Vienna, its health needs and the demands it places on the health service. Unfortunately, for reasons of space, it is not possible to do justice to the various contributions by discussing them in detail.

Workshops and Summary

Several workshops were arranged to allow participants to respond to what they had heard at the congress. Delegates were encouraged to express their opinions, offer ideas and make recommendations. One workshop focused on Economics in Healthcare, while a second took as its theme the issue of Care for the Elderly. Reports on the conclusions reached at the workshops were delivered in the plenary session and revealed a wealth of creative and innovative proposals. While the congress may not have found a panacea for all healthcare ills, it produced many useful ideas. The collective knowledge of the health professionals in attendance demonstrated that there is no shortage of good ideas in the health and hospital sectors. The problem in many cases, one which is not confined to Austria, is the inability of policymakers and healthcare providers to translate ideas into action.

(1) “50 Jahre Arbeitsgemeinschaft” is available in German only at www.argev-wien.at/show_2308.aspx (2) See Hospital 1/2008, pages 35 and 36: Hradsky, J. “The Austrian Association of Hospital Managers” (3) An overview of the Congresses is available in German only at www.argev-wien.at/show_2278.aspx

Author:

Regierungsrat Josef HRADSKY

Working Group of Health Managers

and

Karl Landstein Institute for Hospital

Organisation, Vienna

E-mail: [email protected]

Website: www.argev-wien.at and

www.karl-landsteiner.at/institute/krankenhausmanagement.html