Change in law necessary so that health insurance companies pay for wound treatment

2024-04-07 08:06:04

Ombudsman Achitz: Wound treatment by nursing staff with special training in wound management must be included in the ASVG list

Vienna (OTS) – Eveline F. suffered a small injury to her heel regarding a year ago. Because the wound wouldn’t heal, she first went to the family doctor and then to a dermatologist. However, their weeks-long treatment attempts were unsuccessful. Next, F. tried hospitals, but that didn’t work either. Eveline F. might only be helped with wound management in Salzkammergut. She has been receiving treatment there since December and has paid more than 6,000 euros so far. She remains stuck with these costs because the Austrian Regional Health Insurance Fund (ÖGK) does not cover any of it. Ombudsman Bernhard Achitz: “The ÖGK cannot be blamed; it is not allowed to pay. A change in the law is necessary so that wound treatment by wound managers also becomes a health insurance benefit.”

“Indignant and outraged”

Eveline F. contacted the Ombudsman. “I am outraged and indignant that the costs of professional treatment are not covered by the health insurance,” she said on the ORF program “Citizen Lawyer”. The problem: The costs of medical treatment are only covered by the health insurance company if they are provided by service providers listed in the ASVG: doctors, hospitals, physiotherapists, speech therapists, occupational therapists, clinical psychologists, Psychotherapists and therapeutic masseurs. Wound managers are missing from the list, so patients have to pay themselves.

Paradox: Treatment at home would be more expensive, but health insurance would pay

For Ombudsman Achitz, it is particularly paradoxical that the same services are covered if they are provided as part of medical home care, for example: “Mrs F. is able to drive herself to wound management and has to pay in full. The mobile service would be covered by the health insurance, although the costs are much higher.” The costs would also be covered for doctors, but in many regions they lack specialist training or have too little time for such intensive treatments.

Keyword wound management

Wound treatment or wound management is the assessment, cleaning and care of wounds. These include the administration of special injections or infusions, tube feeding, wound care (decubitus care), stoma fistula and catheter care. Wound management is carried out in both outpatient and inpatient facilities. The knowledge for professional wound management is acquired through further training within the framework of Section 64 of the Health and Nursing Act. Members of the senior health and nursing service are entitled to complete these further training courses.

SERVICE: The Ombudsman can be reached at post@volksanwaltschaft.gv.at and on the free service number 0800 223 223.

Questions & Contact:

Florian Kräftner
Media spokesman in the office of Ombudsman Mag. Bernhard Achitz
+43 664 301 60 96
florian.kraeftner@volksanwaltschaft.gv.at
volksanwaltschaft.at

1712478862
#Change #law #health #insurance #companies #pay #wound #treatment

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