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centres so far (Schweizer Haus Hadersdorf, Zukunftsschmiede Voggeneder, GrünerKreis, PASS, DIALOG, BASIS and Psychosocial Services of Burgenland). Under the lumpsum agreements, the treatment centres in question are obliged towards the FederalGovernment to provide, for fees not exceeding the maximum fees defined, inpatientand outpatient treatment and counselling services, including medical supervision ofthe patients' state of health, medical treatment including withdrawal and opioidsubstitution treatment, as well as treatment and counselling by clinical psychologistsor psychotherapists. The lump sums agreed upon are index-linked and annuallyadjusted for inflation on the basis of the consumer price index, and the new lumpsums are communicated by decree (latest adjustment in 2010: JMZ 703015L/1/II2/10).It would be in the interest of the Provinces if a greater number of treatment centresconcluded cost-coverage agreements with the Ministry of Justice regarding healthrelatedmeasures, in particular outpatient services (Hörhan, personal communication).The majority of drug treatment centres receives public funding. A few non-profitassociations raise a certain share of their income themselves by selling products andproviding services (e.g., postal dispatch services or renovation work). In this field,profit-oriented enterprises have never played a significant role in Austria. The fundsprovided by public authorities, also by the Federal Government, go directly to theowners of the corresponding treatment centres and projects. The complex legalsituation on which the system of funding of addiction-related services by publicauthorities is based has repeatedly given rise to controversy between federal andprovincial governments, and many attempts have been made to resolve this matter. Atpresent, a working group established by the Drug Forum is discussing this issue (seeChapter 1.2).12.2 Cost of inpatient treatmentThe cost of inpatient treatment in hospitals because of drug problems may beassessed on the basis of days of hospital stay by patients with drug-related primarydiagnoses (F11, F12, F13, F14, F15, F16 and F19) multiplied by the average cost of oneinpatient day (see Table 12.1). However, one has to bear in mind that there are cases inwhich accounting and cost coverage aspects may have an influence on the codesentered.No detailed information can be given on cost of inpatient treatment in drug treatmentcentres that are no hospitals. However, in the case of centres covered by the DOKLIdocumentation, approximate figures for days of stay and funding sources involved can110 © GÖG/ÖBIG, <strong>Report</strong> on the Drug Situation 2010
e given (Vienna is not included, however) 49 . In 2009 a total of 762 people weretreated in non-hospital centres covered by DOKLI, with an estimated total of 102 930days of stay. It shows that the majority of costs has been taken over by the provinces(61%), followed by the court authorities (38%).Table 12.1Estimated cost of inpatient hospital treatment of people with drug-relatedprimary diagnoses, from 2001 to 20082001 2002 2003 2004 2005 2006 2007 2008Stays in hospital 4 795 4 981 4 984 5 258 5 252 5 611 5 781 5 873Days of hospital stay 84 299 88 481 89 638 93 745 98 571 113 266 111 672 118 559Estimated cost (EUR)* 18.4 19.9 20.7 22.2 24.1 28.4 28.7 31.2Note*: Figures relate to million euros.Source: BMG — DLD 2001–2009; calculation and representation by GÖG/ÖBIGIt was not possible to derive the average cost of one day of hospital stay. In 2009 thecourt authorities spent a total of EUR 7 032 611 for health-related interventionsaccording to Section 41 of the SMG. This expenditure includes both inpatient and outpatientservices, however (communication by the Federal Ministry of Justice).12.3 Cost of outpatient treatmentIt is not possible to break down the number of people receiving outpatient treatment inhospital in the same way as that of inpatients because no comparable documentationsystem exists for outpatient departments. However, the majority of specialised drugoutpatient departments of hospitals communicate data to DOKLI and have thereforebeen included in the table below.Table 12.2 shows that the largest share of outpatient treatments expenses are coveredthrough the drug treatment centres on a basis other than per-case funding. The49For estimating days of inpatient stay, the number of people in treatment on 30 June 2009 (282 patients) wasmultiplied with 365. The percentage of actual funding sources, investigated at the end of treatment, relates tothose 507 patients who were released from inpatient treatment in 2009 (multiple answers were permitted). Thefigures given do not include Vienna because data on funding sources are not transferred from Vienna's BADOdocumentation system to DOKLI, therefore it is not possible to distinguish between hospitals on the one handand non-hospital treatment centres on the other (see GÖG/ÖBIG 2010a).Chapter 12 / Cost of Drug-related Treatment 111
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Report on the Drug
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ISBN-13 978-3-85159-153-8Owner, edi
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PreventionThe trend towards drawing
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hardly known. This makes it impossi
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6 Health Correlates and Consequence
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Tables and FiguresTablesTable 6.1Ta
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Table A22Table A23Table A24Table A2
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Figure 9.1Figure 9.2Figure 9.3Figur
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Part ANew Developmentsand Trends
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The amendment to the Narcotic Drugs
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deaths (see GÖG/ÖBIG 2009b) conti
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In the reporting period, no new dev
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2.1 Drug use in the general populat
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The quitting rate 3 is considerably
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Figure 2.2Experience of cannabis us
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described on the individual website
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ehaviour is elevated for children i
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theme of the Gesunde Gemeinden (hea
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party scenes are relevant settings.
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support if needed. The project is i
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approximations and have to be inter
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Figure 4.22-sample CRC estimates wi
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5 Drug-related Treatment: Treatment
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2010, now 50 doctors are entitled t
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patients for inpatient treatment al
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Map 5.2Specialised providers of out
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cooperation structures linking the
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events are organised, and on the ot
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5.3 Characteristics of treated clie
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play the most important role in the
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existing treatment system who do no
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5.4 Trends of clients in treatmentA
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Figure 5.7First substitution treatm
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6 Health Correlates and Consequence
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Table 6.1Data on hepatitis B, hepat
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ange from affective disorders (e.g.
Page 76 and 77: Figure 6.1Share of directly drug-re
Page 78 and 79: In the EMCDDA working group on coho
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Page 82 and 83: 7.2 Prevention and treatment of dru
Page 84 and 85: distribution of condoms) is provide
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Page 88 and 89: While smaller shares of women state
Page 90 and 91: Map 8.1Specialised providers of inp
Page 92 and 93: The Lighthouse housing project of M
Page 94 and 95: empowerment that had been aimed at,
Page 96 and 97: handling of drugs: Section 27 of th
Page 98 and 99: also shows regarding prison sentenc
Page 100 and 101: Stadtpark, and Westbahnhof station.
Page 102 and 103: mation on final convictions because
Page 104 and 105: practitioners and psychiatrists). I
Page 106 and 107: 10 Drug MarketsThe substance most f
Page 108 and 109: head shop in Graz (Styria) in Augus
Page 110 and 111: (from 2005 to 2008, the correspondi
Page 113: Part BSelected Issues
Page 116 and 117: national quality standards for medi
Page 118 and 119: Also, both at federal and provincia
Page 120 and 121: Table 11.1, continuedTitle and year
Page 122 and 123: Plans for new guidelines and standa
Page 124 and 125: 12 Cost of Drug-related TreatmentTh
Page 128 and 129: greatest percentage of the respecti
Page 130 and 131: (e.g., days of hospital stay becaus
Page 133 and 134: BibliographyAPA 2010. AIDS 2010. Wi
Page 135 and 136: EMCDDA 2000. Treatment demand indic
Page 137 and 138: Haas, S. (2005). Problembewusste Fr
Page 139 and 140: Pont, J.; Wool, R. (2006). Ein Leit
Page 141 and 142: VIVID 2010. Jahresbericht 2009. VIV
Page 143 and 144: Personal Communications(alphabetica
Page 145 and 146: Caritas Marienambulanz. Drug relate
Page 147 and 148: Low threshold service Ganslwirt(Ver
Page 149 and 150: Viennese pilot project “Pregnancy
Page 151 and 152: Lower Austria: Fachstelle für Such
Page 153 and 154: Caritas Innsbruckhttp://www.caritas
Page 155 and 156: Otto-Wagner-Spital — Drogeninstit
Page 157: AnnexA. Tables, MapB. List of Abbre
Page 161 and 162: Table A1Overview of selected genera
Page 163 and 164: Table A2, continuedStudy(author(s),
Page 165 and 166: Table A5Number of directly drug-rel
Page 167 and 168: Table A7Distribution of directly dr
Page 169 and 170: Table A11Distribution of reports of
Page 171 and 172: Table A15Final convictions under th
Page 173 and 174: Table A18Seizures of narcotic drugs
Page 175 and 176: Table A22Persons starting drug trea
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Table A24Persons starting drug trea
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Table A26Persons starting drug trea
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Table A29Current health problems of
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The programme plus is implemented i
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Proven regional interventions run f
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Table A34Austrian population statis
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Annex BList of Abbreviations
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HCVHCV-AbHCV-RNAHIVICD-10IFESISDISP
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List of Standard Tables of 2010 and
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