[Health care costs of multiple sclerosis in Austria. Cross-sectional study including consideration of quality of life]. / Krankheitskosten der multiplen Sklerose in Osterreich. Querschnittstudie unter Berücksichtigung der Lebensqualität.

A retrospective, cross-sectional study was performed to evaluate direct and indirect costs related to multiple sclerosis (MS) in Austria in a representative cohort of patients ( n=895) with typical symptoms. Demographic, socioeconomic, and disease-related data including degree of disability and health-related quality of life as well as consumption of medical and nonmedical resources were recorded and mean total costs per patient and year were calculated (based on 1999 figures). Total direct costs borne by public sources were 15,684 euro per MS patient per year. Overall societal costs increased disproportionately with the progression of the disease, from 12,990 euro per year in patients with mild disability to 69,554 euro per year in patients with severe disability. Increasing disability was reflected by substantial deterioration of health status-related quality of life. Direct costs of MS in Austria are similar to those in other countries.

["Parents' salary" and "freedom of choice" between paid and unpaid work: empirical results of a controversial concept]. / "Erziehungsgeld" und "Wahlfreiheit" zwischen Erwerbs- und Familienarbeit: empirische Evidenz zu einem kontroversiellen Konzept.

The author summarizes results from a study on the impact of a parents' salary in Vorarlburg, a province in western Austria. "According to this concept parents are 'paid' by the government for taking care of their children during the first years after birth, while giving up paid work in the labour market. Critics oppose this concept because of its potentially negative implications for the labour force participation of women.... It is shown that the public transfer payment substantially improves the financial situation of the families involved but also affects the distribution of money and power between the spouses within the households. Moreover, it is pointed out that the payment of a parents' salary itself has 'asymmetrical' effects, which could be balanced if more efforts were made to improve the child care facilities for children under three." (SUMMARY IN ENG)

Reforming health care for the elderly--the example of Vorarlberg.

Vorarlberg--Austria's most western province with a population of about 325,000--has always implemented forms of social policy in which the principles of subsidiarity and solidarity play an important role. This is reflected in the structure of the organizations traditionally providing social services as well as in the more recent programmes the government has developed for social policy. This paper discusses two cases in point: the private associations for home care (Krankenpflegerverbände)--which now exist in 65 Vorarlberg communities and cover 85% of the population in the province--offering nursing services at home to members or to persons who are willing to join the organization when they need care, and the new organizational model, called Gesunder Lebensraum Vorarlberg (GLV), which is successfully operating in a few pilot communities. GLV has spawned umbrella organizations, run by volunteers, and offering a variety of social services relevant to the elderly, for example visiting services or neighbourhood help in case of emergencies. The volunteers get organizational help from a profit-making firm financed by the government. The Vorarlberg models can be interpreted as a step towards demedicalization and deinstitutionalization of health care for the elderly. Nevertheless, they also show the problems that arise when professionals and volunteers must cooperate. The models may lead to savings for the governments involved, although details are still subject to future empirical investigations.