9 countries and 3+ health insurance companies - Long wait for intensive care at home

Time and again, people contact the Austrian Ombudsman Board because they feel they have to wait for ages to be granted the intensive care they need at home. In most cases, this concerns patients who need to be ventilated. "The medical necessity is clear. It is also clear that they have a right to be treated at home. But they are put off alternately by the state and the health insurance company, with the argument that the other side is to blame," reports Ombudsperson Bernhard Achitz: "Everyone involved is calling for a standardised regulation for the whole of Austria. But as there are nine federal states as well as three large and a few small health insurance funds, this may take some time. Until then, it must be made clear that care will be provided immediately. The provinces and health insurance funds should then work out in the background who pays how much. These discussions must not be carried out on the backs of the people!"

Wolfgang A.: Ombudsman Board obtains authorisation - care at home secured

"Thanks to several Supreme Court judgements, it is clear that if those affected do not want to go into a home, but would rather live at home with their families, then the state and social insurance are jointly obliged to finance the expensive intensive care at home," says Achitz. When the Ombudsman Board gets involved, a solution is usually found. On 27 September, Achitz was able to report in the ORF programme "Bürgeranwalt" that the 24-hour intensive care for Wolfgang A. from Salzburg, who has been paralysed from the neck down since a serious cycling accident and cannot breathe on his own, is now working. Two qualified carers take turns looking after him at home.

Wolfgang W. wants to live in familiar surroundings and continue working

In the same programme, Ombudsperson Achitz reported on another man who has been waiting a year for approval for intensive care at home. 45-year-old Wolfgang W. has to be ventilated due to muscular dystrophy. His parents are still responsible for a large part of his care, but this is becoming increasingly difficult due to his age. However, W. wants to remain in his familiar surroundings and carry out his job. "Life would otherwise be over for me," he says. The ÖGK (Austrian Health Insurance Fund), whose medical service already approved the application for intensive home care in April, and the Styrian Health Fund both refer W. to the lack of decisions from the other side. However, the medical director of ÖGK, Andreas Krauter, has now announced a swift solution.