Amendment Of The Federal Law On Hospitals And Sanatoria

Original Language Title: Änderung des Bundesgesetzes über Krankenanstalten und Kuranstalten

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147. Federal law amending the federal law on hospitals and courting companies

The National Council has decided:

Federal law on hospitals and health care institutions, BGBl. No. 1/1957, as last amended by the Federal Law BGBl. I n ° 69/2011, is amended as follows:

Part 1
(Basic provisions)

1. In Section 2a (1) (lit). a is the entry part:

"In accordance with the conditions laid down in paragraphs 4 and 5, standard hospitals with departments at least for:"

2. In Section 2a (1) (lit). b is the entry part:

"Priority hospitals, in accordance with paragraph 5, with departments at least for:"

3. In Section 2a (2), the word order shall be deleted "at least to this extent" .

4. In Section 2a (3), the expression " 1 lit. b and c " by the expression " 1 " and the expression "§ 3b" by the expression "§ 3d" replaced.

5. § 2a (4) is replaced by the following paragraphs 4 and 5:

" (4) The national legislation may provide for the provision of standard hospitals, which shall be 1. In January 2011, a final authorisation and operating permit may be used as standard hospitals for basic services provided that they have a natural catchment area of less than 50,000 inhabitants and/or if the availability of a standard hospital according to para. 1 lit. a or a higher-level hospital according to para. 1 lit. b or c. For standard health care providers, the following shall apply:

1.

Standard hospitals of basic services must at least:

a)

lead a department of internal medicine without any further specialization,

b)

An organizational unit based on basic services in the sense of the performance matrix of the Austrian Structural Plan Health (ÖSG) and guided in a reduced form of organization according to § 2b para. 2 Z 3 or 4 Basic supply in surgery and

c)

Ensure a permanent initial supply of acute cases together with the assessment of the further treatment requirements and forwarding for the follow-up treatment into the relevant supply structure.

2.

In addition, further reduced organizational forms according to § 2b, limited to basic services within the meaning of the performance matrix of the ÖSG, can be conducted in conjunction with paragraph 5 for operative specialization.

3.

The organization of the more complex medical care required in accordance with patient requirements is by cooperation with a standard hospital according to para. 1 lit. a, a higher-level hospital according to para. 1 lit. b or c or a suitable special hospital in accordance with § 2 para. 1 Z 2.

4.

An extension of the power spectrum beyond the basic supply services in the sense of the performance matrix of the ÖSG is inadmissible.

5.

If necessary, supplementary equipment for acute geriatrics/reobilisation or reobilisation/aftercare should be taken into consideration in accordance with § 18. The continuation of other existing disciplines, insofar as they are conservative, in an organizational form according to § 2b is permissible only in exceptional cases and if this is provided for in the respective regional structural plan health.

6.

Standard hospitals of the basic supply can also be used as dislocated premises of a spatially close standard hospital according to para. 1 lit. a or a hospital of a higher level of care in accordance with para. 1 lit. b or c.

(5) The national legislation may be applicable to hospitals pursuant to para. 1 lit. (a) and (b) and (4) where provision is made there and, in accordance with § 2b, provide for the establishment of the following reduced forms of organisation:

1.

Departments

a)

for trauma surgery in the form of satellite departments (§ 2b para. 2 Z 1),

b)

for acute geriatrics/Remobilisation within the scope of departments for internal medicine or departments of neurology,

c)

for plastic, aesthetic and reconstructive surgery within the scope of departments for surgery,

d)

for psychosomatics for adults as a priority within the framework of departments of psychiatry or for internal medicine and

e)

for child and adolescent psychosomatics as a priority within the framework of departments for children's and adolescent medicine or for child and adolescent psychiatry.

2.

Specials for the medical special subjects ophthalmology and optometry, neck, nose and ear diseases, oral and maxillofacial surgery, orthopaedics and orthopaedic surgery as well as urology,

3.

disloted weekly clinics for each special subject as well as

4.

disloted daycare clinics for every special subject.

The establishment of reduced forms of organization is with the exception of the Department of Psychosomatics (Z 1 lit. (d) and (e) only in justified exceptional cases, such as the coverage of gaps in the supply of supply in peripheral regions or the production of a regionally balanced supply where the economic operation of a division lacks sufficient Capacity utilization cannot be expected. "

6. In accordance with § 2a, the following § § 2b and 2c shall be inserted together with the headings:

" Speciality-related organizational forms

§ 2b. (1) Departments are bed-leading facilities which are to be operated fully in time and which, in the context of the coverage of the training-related supply needs of the population in their catchment area in accordance with section 8 (1) thereof, are To ensure the availability of professional acute care for persons in need of special care in the respective special subject.

(2) In addition to departments or In accordance with Section 2a (5), the following organization-related forms of organization may be held in place of departments as organisational units:

1.

Departments as bed-leading facilities with limited services in the sense of the performance matrix of the ÖSG for Accident Surgery (satellite department) or Plastic, Aesthetic And Reconstructive Surgery with 15 to 24 beds each, for Akutgeriatrics/Remobilisation with at least 20 beds as well as for psychosomatics and children's and juvenile psychosomatics with at least 12 beds. Departments must, with the exception of satellite departments for trauma surgery, be operated in full time in accordance with § 8 (1), have at least three specialists in the reserved area and within the framework of a specialist department be set up within the hospital in accordance with § 2a (5) (1) (1). Satellite departments for trauma surgery are part of the medical institution in which they are operated. The medical care of the satellite departments is provided by a department of trauma surgery of another hospital or-in the case of a hospital with several locations-by a department of trauma surgery on another To ensure the location of the hospitals.

2.

Specialist areas of expertise as bed-leading institutions with eight to fourteen beds and with elective interventions limited service offerings in the sense of the performance matrix of the ÖSG for the medical special subjects according to § 2a (5) Z 2. may have limited operating times if a readiness to call is ensured outside these operating times. Specialist areas must have at least two specialists in the field of expertise and, if necessary, further specialist doctors to cover their readiness to call, and to a department of the same specialist direction of another hospital be attached. The establishment of specialist focus points can be found in standard hospitals according to § 2a para. 1 lit. a and § 2a (4) in addition to the departments to be held as well as in priority hospitals according to § 2a para. 1 lit. b also take place as a replacement of departments to be held.

3.

Dislocated weekly clinics as bed-leading establishments whose medical care is provided by a division of the same subject, which is located in another hospital, or is set up at another hospital location (parent department). They are used for carrying out treatments with a short residence time, the range of services being restricted to basic supply services in the sense of the performance matrix of the ÖSG. The establishment of dislozated weekly clinics is only available in standard hospitals according to § 2a para. 1 lit. a and in priority hospitals according to § 2a para. 1 lit. b in addition to the departments of the hospitals to be held and in standard hospitals of the basic services according to § 2a (4) as a replacement of a department of surgery as well as in other fields of specials. Disloted weekly clinics must be provided, provided that the establishment regulations do not deviate from the rules for public holidays within the meaning of § 6 para. 1 lit. b contains, at least from Monday morning until Friday evening, fully operated in the evening. If necessary, the parent department must ensure the necessary follow-up care for non-redundant patients outside of the operating period.

4.

Dislocated day clinics as bed-leading facilities at locations of hospitals without a fully inpatient bed-leading facility (department, department or specialist focus) of the same special subject with an elective on a day-to-day basis. Offering conservative and operational services with limited services in the sense of the performance matrix of the ÖSG. Dislocated day clinics can either be run independently in the hospital in question and be connected to a department of the same subject area of another hospital, or can also be set up as bed-leading institutions, whose medical care is provided by a department of the same subject, which is located in another hospital or is set up at another hospital location (parent department). They have limited operating times. In any case, the necessary post-operative and conservative aftercare is to be ensured outside the operating period. Disloted day clinics can be found in standard hospitals according to § 2a para. 1 lit. a and in priority hospitals according to § 2a para. lit. b in addition to the departments to be held, as well as in standard hospitals, in accordance with § 2a (4) as a replacement of a department of surgery as well as in other fields of speciation.

Reference centers

§ 2c. The reference centres are specialised structures within the framework of the bed-leading organisational structures, which in principle are concentrated in the centre of gravity or central hospitals for the bundling of the provision of complex services for the following areas: can be set up:

1.

Cardiac surgery, thoracic surgery, vascular surgery, transplant surgery, interventional cardiology, oncology care, stem cell transplantation, nuclear medical inpatient therapy and nephrology for adults including children, who the 15. have been completed, as well as

2.

Cardiac surgery, transplant surgery, interventional cardiology, oncological care and stem cell transplantation for children, which is the 15. They have not yet completed their life year. "

(7) The following paragraph 6 is added to section 5b:

" (6) The state legislation has to oblige the institutions of the hospitals to participate in a regular Austrian-wide quality reporting and to do so in accordance with § 6 of the Federal Law on the Quality of Health Services, BGBl. I n ° 179/2004, to provide the necessary non-personal data to the Federal Ministry responsible for the health care sector, provided that these are not to be reported in any case on the basis of other documentation obligations. "

8. § 6 (1) reads:

" (1) The internal operation of the hospital is regulated by the Anstaltsordnung (Anstaltsordnung). The national legislation has to lay down more detailed rules on the content of the rules of the law, which in particular have to be included:

a)

the tasks and facilities of the hospital, in general hospitals and special hospitals, also a possible breakdown in departments and/or in other organisational forms related to the subject of acute care, and, in addition to these, also in additional facilities for long-term treatment, or in care groups for the treatment of acute care patients and for long-term treatment within departments;

b)

the broad lines of its administration and its mode of operation, in particular whether, instead of or in addition to the traditional type of operating mode, people in need of an operation only have a single day (day clinic) or overnight (night clinic), or in the longer term, in the semi-stationary area where they are only staying overnight, or only overnight, or in other forms of operation as referred to in paragraph 7;

c)

rules relating to the management of the organisation forms referred to in Article 2b and of the forms of operation referred to in paragraph 7;

d)

Regulations on the operation of disloted weekly clinics on public holidays;

e)

the professional duties of persons employed in the hospital and provisions on the regular holding of meetings of services between the occupational groups concerned;

f)

the behaviour to be observed by Pfleglingen and visitors to the hospital;

g)

the establishment of spaces where smoking is permitted;

h)

Regulations relating to the internal relationship between hospitals in the case of organisational units (§ 2b) or in disloted forms of operation (§ 6 (7)). "

9. § 6 para. 2 reads:

" (2) The individual organisational units and care groups shall be kept in a manageable size with regard to their number of beds, taking into account the subject and the progress of medicine. If beds are available for pawnlings of organizational units of different special subjects (interdisciplinary guided areas), appropriate measures must be taken to ensure that the peaces are at all times without doubt a certain subject-specific organizational unit. "

10. The following paragraph 7 is added to § 6:

" (7) The following types of operating forms are possible in hospitals in addition to the conventional type of technical and/or time-to-use operating mode:

1.

Interdisciplinary guided areas for the treatment of pests from various special subjects, which are held in the hospital in one of the direction-related organizational forms according to § 2b. It is necessary to ensure that the pawnlings can be assigned to a certain special subject at any time without any doubt.

2.

As a weekly hospital bed areas for inpatient treatment of cases where dismissal within the approved operating time is to be expected. Weekly clinics can be operated in a subject-specific or interdisciplinary manner in the sense of the Z 1.

3.

Bedside areas lead to daily clinical treatment (admission and dismissal on the same day). The range of services is limited to daily clinically available conservative and elective operational services. Day clinics can be operated in a subject-specific or interdisciplinary manner in the sense of the Z 1.

4.

Central reception and primary care units as facilities with full operating time, consisting of a first-time outpatient clinic and a reception area with (systemised) beds subject to authorisation for stationary observation of Pfleglingen for a maximum of 24 hours. The range of services allowed includes the implementation of an outpatient initial supply of acute and emergencies, including basal accident care, as well as initial assessment and, if necessary, initial treatment of other unplanned access points, including the assessment of the further treatment requirements and forwarding for subsequent treatment into the relevant specialist structure within or outside the respective first-serving hospital in the inpatient or outpatient area, the short inpatient treatment or Observation up to 24 hours as well as the organizational takeover unplanned stationary recordings outside of routine operating times (night-time) with installation on suitable normal care areas at the beginning of the routine service (daytime service). A dislocated management of these facilities is only permitted in justified exceptional cases, such as coverage of supply gaps in peripheral regions or for the production of a regionally balanced supply.

5.

Outpatient first-care unit as an interdisciplinary structure for the initial assessment and, if necessary, initial treatment including the assessment of the further treatment needs and, if necessary, the transfer of the paselings into the required Ambulant or inpatient care structure. The outpatient primary care unit may have an adequate number of non-taxable beds (functional beds) which provide for short-term accommodation for the implementation of outpatient diagnostic and therapeutic measures is indispensable. Disloted guided outpatient primary care units are to be operated in full time. Ambulatory first-care units, which are operated locally in a hospital or in the immediate vicinity of a hospital, can set the holding for a maximum of 8 hours, which are to be laid down in the Anstaltsordnung daily, if the performance of the tasks of the ambulatory first care unit by the hospital is ensured in another form. In other respects, Z 4 and § 26 shall apply in a reasonable way. "

11. In Section 8 (1), the names of Z 6 to 8 are given the names "8." to "10." ; after Z 5 the following Z 6 and 7 are inserted:

" 6.

in disloted weekly clinics, the determination of the readiness to call in accordance with Z 3 and 4 shall apply mutagenically and may be waived from a permanent presence of specialist physicians of the special subjects eligible outside the operating hours, if: In case of need, the maintenance of the noselings by the parent department outside the operating time is ensured;

7.

in dislocated daycare clinics, it is possible, outside operating hours, to be subject to a permanent presence of specialist physicians of the eligible special subjects, provided that the necessary post-operative and conservative follow-up care is ensured; "

12. In Section 10a (2), in the Z 4, the word "Organizational Units" through the phrase "Direction-related organizational forms" replaced.

13. § 10a (2) Z 6 reads:

" 6.

the maximum number of beds per department in relation to the country and the supply regions, or in relation to the locations, "

(14) The following paragraphs 3 and 4 are added to § 10a:

" (3) The provisions of Section 2 (6) do not apply in relation to the sites. In connection with § 3 (2b) and (2c), the bed capacities intended for realization per department and location are at least in the Regional Structure Plan Health to be non-binding with information character.

(4) The national legislation must oblige the state government to ensure the regional structural plan for health on the home page of the respective country, which is coordinated at the national level between the country and the social security system in the state health platform. to be published in the current version. "

15. § 14 reads:

" § 14. Public hospitals shall be understood to mean hospitals of the species referred to in Article 2 (1) (1) (1) (1) to (3), to which public law has been conferred. "

16. § 18 (2) reads:

" (2) Depending on the local conditions, a standard hospital for 50,000 to 90,000 residents (§ 2a para. 1 lit. a and para. 4) and for 250,000 to 300,000 inhabitants a priority hospital (§ 2a paragraph 1 lit. (b) to be set up; the establishment of a standard hospital may be waited if, in the respective catchment area, the conditions set out in § 2a (1) (lit). a or paragraph 4 is fulfilled by departments or other organisational units which are disloted by a centre of focus; in each country the number of inhabitants of which exceeds one million, a central hospital (§ § § § 3) 2a, paragraph 1, lit. (c) be established. National legislation can determine that these figures may be exceeded in the presence of particular topographical or traffic conditions, but at least one priority hospital is available in each country. "

(16a) The following paragraph 6 is added to Article 22:

"(6) In the case of the treatment of a plea in an organisational unit (§ 2b) or in disloted forms of business (§ 6 (7)), the pledge is one of the hospitals in which he is located."

17. § 40 para. 1 lit. c and d is:

" (c)

§ § 16, 19a, except para. 4, 23 (1), 24 (1) second and third sentence, 24 (2), with the proviso that the Code of refund and the Directive on the economic prescription of recommendations on further medication are only to be found in shall be taken into account if the Pflegling is to receive the cure at the expense of a sickness insurance institution, § § 24 (4), (26) and (35) (3).

d)

In addition, § § 19a (4), 27, 27a, 28 (3) and (4) and 32 (32) shall apply to non-profit-making hospitals (§ 16). "

Part 2
(Federal Law Applicable directly)

18. According to § 59i, the following § 59j is inserted:

" § 59j. The Federal Minister responsible for the health sector has, in any case, on the homepage of the Federal Ministry of Education and Research

1.

the current Austrian structural plan health, which is to be viewed as objectified expert opinion

2.

the current model of performance-oriented hospital financing and

3.

the current basis for the documentation on the basis of the Federal Act on Documentation in the Health Care

"

19. The following para. 4g to 4i shall be added to § 65:

" (4g) Land legislation has the implementing provisions of § 2a (1) (lit). a and b as well as paragraphs 3 to 5, § 2b, § 2c, § 5b para. 1 and 6, § 6 para. 1, 2 and 7, § 8 para. 1, § 10a para. 2 Z 4 and 6 as well as para. 3 to 5, § 18 para. 2 and § 40 para. 1 lit. c and d in the version of the Federal Law BGBl. I No 147/2011 within six months.

(4h) (determining the principle) The national legislation has to provide that the before 1. Jänner 2012 in the Department of Surgery Departments of the Department of Accident Surgery until 31 December 2015 in satellite departments according to § 2a paragraph 5 Z 1 lit. a are to be converted.

(4i) (determination of principles) The national legislation must provide for the prior to the first Jänner 2012 within the framework of the Department of Surgery Departments of the Department of Mouth, Maxillofacial Surgery and Facial Surgery until 31 December 2015 are to be transformed into specialist areas according to § 2a paragraph 5 Z 2. "

Fischer

Faymann