Development of national health care guidelines in Austria. Gesundheit Österreich GmbH/BIQG

CONTEXT: The Austrian health system is characterized by fragmentation of policy and financing. Therefore, an institute for quality in the health system was founded to bridge the gap between different interests and to bring forward quality work in the whole health system. One of the first tasks of this institute is the development and implementation of so-called ‘Bundesqualitätsleitlinien’, which mean national transsectoral and transdisciplinal health care guidelines. PURPOSE: The main aim is the implementation of evidence-based integrated health care guidelines on a national level and the improvement of efficiency and effectiveness of the health care system. DESCRIPTION: The guideline work follows national and international evidence and experience under the principle of transparence and consensual multidisciplinary development. Established evidence, such as medical, social and other guidelines may be integrated in the development process and can be declared as part of the final guidelines. Each guideline is developed, discussed and finally accepted by a panel of experts who represent main stakeholders of health system as well as health professionals and patients. While there are fix members, such as federal ministries and patient representatives, the different health professionals are invited as required referring to the topic of the guideline. CONCLUSIONS: At the moment four national quality guidelines for chronic diseases are under development: COPD, diabetes, dementia and Parkinson's disease. Furthermore, a guideline for hospital admission and discharge management is in progress. As the utilization of these guidelines in practice is not predictable yet, the implementation in some regional pilot projects is planned. DISCUSSION: The multidisciplinary and consensual approach leads to the challenge of achieving necessary compromises as well as high quality results. Furthermore, there is no possibility to create and finance new structures any improvements have to be gained through optimized processes which limits the options and possibilities of the guidelines.