ArticleFrontiers in public health2026
Implications of federalism: patterns of healthcare utilisation across Austrian federal states - insights from the Health Interview Surveys.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Austria's nine federal states are responsible for healthcare provision, particularly hospital services. However, differences in political arrangements between states have resulted in spatial disparities in healthcare. This study evaluated whether the utilisation of primary and secondary healthcare services showed regional differences over time. Methods: This analysis was based on data from the most recent Austrian Health Interview Survey (ATHIS) series conducted in 2014 and 2019, with a total of 31,231 participants. Data on physician density and population numbers were retrieved from the Austrian Medical Chamber and Statistics Austria. Healthcare utilisation behaviour was analysed using descriptive statistics, correlation analysis and multivariable logistic regression models. Results: Highly urbanised regions showed higher rates of ambulatory specialist visits compared with less urbanised regions but lower visit counts of general practitioners (GPs). The reversed utilisation trend was observed for regions of low urbanisation (ambulatory specialist visits: OR 0.79, 95% CI 0.72-0.86, Conclusion: Healthcare utilisation varied according to the degree of urbanisation. The increasing utilisation of specialised care is associated with specialist density. These findings should be emphasised in the context of current health reforms in Austria, especially regarding primary care.
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