Transition processes and pathways across Austrian long-term care provision. Lessons to be learnt in a European context

PURPOSE: To draw attention to incentives and disincentives inherent in current health and social care provision in Austria by following common and possible pathways of an older and care dependent person across the Austrian long-term care system. To learn from continuity and discontinuity in transition processes as well as from elements of national and European good practice, which may serve to fill gaps and bridge missing links. CONTEXT: Ageing societies have significantly changed the demand towards current health and social care provision. In particular, a strong increase in multi-morbidity and chronic diseases, often affecting all different dimensions of human life, has elucidated the urgent need for intensified cooperation and better coordination within and between health and social care provision. However, transition processes, which may efficiently link the different health and social care service sectors and which allow to optimally and with dignity deal with complex individual situations, are often hindered or even blocked by inappropriate regulations or disincentives inherent in the present systems. The adverse effects of such disincentives usually become apparent in regularly recurring troubles and sometimes even paradox situations for users and providers at the level of everyday practice. To follow the pathway of a common example case and to use it for a systematic survey and analysis of transition processes at the practical level is expected to facilitate the insight in underlying incentives and disincentives. To additionally put such pathways in a wider European context and comparison allows the highlighting of national and international initiatives of good practice and to bring to light regulations, which are well or inappropriately adapted to current needs.