Austria has a long history of social protection through the social health insurance (SHI) system. Insurance coverage is mandatory and the assignment to a particular insurance fund is determined by law, depending on the place of occupation, type of occupation and occupational status (unemployed, retired person, and so on). This means that there is no regulated competition between SHI funds in Austria and the level of SHI coverage is very high. Around 99.9 per cent (8.8 million residents in 2017) of Austrians are covered by SHI. The Austrian healthcare system in general and the hospital sector in particular are characterized by a high degree of fragmentation. Competencies in the field of inpatient care lie with the nine federal states; financing is split between the federal level, the federal states and SHI.
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