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Press Release
Health as a mathematical model - Strategic
management in AIDS prevention and hospital funding
Vienna (FWF) - Having developed into a severe financial problem in many
countries, AIDS has long ceased to be a purely emotional issue. Financial
resources are channelled into preventive measures and into the treatment
of AIDS patients with the aim of achieving maximum efficiency at minimum
cost. Marion Rauner from the Department of Business Studies at the University
of Vienna, sponsored by the Austrian Science Fund (FWF), has developed
mathematical models which show and evaluate the effects of different measures
and thus provide an important basis for future strategic decisions. Her
models also reveal interesting aspects concerning the activity-based hospital
funding scheme introduced in Austria in 1997.
The continuously rising cost of public health systems has resulted in
a more targeted use of financial resources in many countries. Methods
of strategic management are thus also gaining increasing importance in
health care. Mathematical modelling plays an important role in this respect.
It provides decision-makers with simulations that clearly demonstrate
and evaluate the effects of their decisions. Marion Rauner has proved
this point for two thematic areas, which earned her a promotional award
from the City of Vienna. "We analysed and evaluated the measures
launched for AIDS prevention and treatment in different target groups
- homosexuals, prostitutes, drug addicts, heterosexuals etc. - and provided
the institutions active in this area, i.e. the Red Cross, the Austrian
AIDS Organisation, the Federal Ministry etc., with suggestions for future
measures", explains Rauner. She demonstrated, for instance, that
the Red Cross is well advised to continue its present policy of not admitting
certain risk groups as blood donors, since the level of HIV infections
in these groups is still very high. "We also proved that the needle
exchange programme is very successful and effective with regard to AIDS
in the field of drug addicts, but the virus continues to be transmitted
by sexual behaviour. The increased distribution of condoms can be a simple
and effective remedy", says Rauner.
Combined hospital funding recommended
In the second part of the research project Rauner took a closer look at
the Austrian activity-based funding system of Austrian hospitals (LKF)
and compared it to the global budget system used in Canada. "LKF
is based on the remuneration of individual flat rates per case with a
limited total budget. This has the advantage of shorter hospitalisation,
better documentation and a targeted use of resources, but the flat rates
per case may have the effect that hospitals shift their focus in documentation
from cheaper to more expensive patient groups, that they tend to longer
or more frequent treatments in intensive care units, or even discharge
patients simply to re-admit them immediately afterwards", says Rauner,
who succeeded in bringing the annual meeting of the "European Working
Group on Operational Research Applied to Health Services" to Vienna
for the first time. "The comparison with Canada shows that it would
be more sensible to combine the two systems, i.e. fixed cost should be
covered by a global budget, while the variable cost should be remunerated
on the basis of flat rates per case."
Dr. Marion Rauner
Department of Business Studies, University of Vienna
Tel.: ++43 1 42 77-38150
Distributed by:
CLOOS + PARTNER, Public Relations Agency
Tel: ++43 1 710 85 99
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