Rector of the Medical University of Vienna wants to reopen debate on healthcare structures

Hospital outpatient clinics as stopgaps

According to the Rector, the background to the debate is a double burden on the hospitals. On the one hand, many patients can no longer be cared for to a sufficient degree by medical practices with regular opening hours; on the other, there is a lack of viable structures in nursing that would enable discharge from hospital. The consequence is that hospital outpatient clinics take on tasks that did not originally belong to their core remit.

As the sponsoring institution of the Vienna General Hospital (AKH Vienna), the Medical University of Vienna is directly confronted with these questions of care. At the AKH, thousands of patients are treated every day, many of them in outpatient clinics that are open around the clock. The debate about care structures therefore does not affect the hospital in the abstract, but in its day-to-day operations.

International comparison as an argument

Müller spoke out in favor of not conducting the discussion solely within hospital administrations or the Medical Chamber. Rather, representatives from politics, nursing, the established practice sector, and patient groups need to be brought to the table. Only in this way could solutions be developed that go beyond previous practice.

At the same time, the Rector pointed to international comparisons. In several European neighboring countries, cooperation between hospital outpatient clinics, general practitioners, and nursing is more strongly institutionalized than in Austria. Müller suggested that the transferability of such models should at least be examined in part in this country as well.

Restrained reactions from politics and the medical profession

The reactions from politics were restrained. Representatives of the Vienna provincial government emphasized that they were fundamentally open to talks on the further development of the care landscape, while at the same time pointing to ongoing reform processes in the established practice sector. The Lower Austrian provincial government also stated that care at the borders between the federal states was a matter of common concern that had to be tackled in a coordinated manner.

From the medical profession came both agreement with the principle and a word of caution. The Vienna Medical Chamber supports a debate on care structures, but warns against further weakening existing structures in the established practice sector by adding additional tasks for hospital outpatient clinics. What is demanded instead is an expansion of panel-doctor care.

Müller emphasized that his aim was not to weaken individual levels of care. The goal is better coordination between general practitioners, hospital outpatient clinics, and nursing facilities. "Es geht nicht darum, gegeneinander auszuspielen, sondern darum, die Versorgung als Gesamtsystem zu denken", said the Rector.

Series of events planned for autumn

Next week, the Medical University of Vienna, together with AKH Vienna, intends to launch a series of events in which the topics of care, nursing, and emergency medicine will be discussed publicly. Representatives from science, politics, and practice have been invited. The university leadership expects results from the series in autumn.

Regardless of the outcome of the debate, the outpatient clinic at AKH Vienna is already considered one of the country's largest outpatient care providers. At the Währing site alone, and together with its external locations, several hundred thousand outpatient treatments are carried out every year. A reform of care structures would therefore have direct effects on the care of many people in Vienna and beyond.

Müller announced that the university would contribute its expertise to the upcoming legislative period in the National Council. It wanted to position itself more strongly not only in the training of the next generation of physicians, but also in shaping the care landscape.