August Österle

The formal employment of family caregivers represents a rather uncommon form of organising long-term care but exists in diverse welfare states. Against this background, we examine how family carers experience a formalisation of previously unpaid care by drawing on two Austrian employment programmes and discuss their larger implications with regard to the (de)familialisation of long-term care responsibilities. Depending on the welfare state context, employment models might either provide freedom of choice with regard to the preferred care arrangement and strengthen a right to care or contribute to the enforcement of family care and thereby reinforce pressures on caregiving relatives.

Purpose: The purpose of this paper is twofold: First, it analyzes demand and supply-side factors that influence patient flows to and from Austria. Second, building on the empirical research and existing conceptualizations, the study offers a general extended framework to guide future comparative analysis.Design/methodology/approach: The paper draws on multiple data sources including a literature review, secondary data, website analysis and semi-structured interviews with patients and health providers. Content analysis was carried out to identify common motives for seeking care abroad and providers' orientation towards medical travel.Findings: Outbound medical travel is largely determined by factors of access, affordability and vicinity, while inbound medical travel is predominately driven by a lack of adequate medical infrastructure in source countries and quality, both in terms of medical and service quality. Providers distinguish themselves according to the extent they take part in medical travel.Research limitations/implications: The findings emerging from a single country case study approach cannot be generalized across settings and contexts, albeit contributing to a better understanding of current medical travel patterns in Europe.Originality/value: Unlike most recent contributions, this study focuses both on inbound and outbound medical travel in Austria and investigates patient flows for distinctive treatments and drivers. While analysis of the supply-side of medical travel is often limited to tourism studies, this study provides a critical insight into developments in Europe from a health policy perspective, acknowledging that diverse medical travel patterns in Europe coexist.

Turkey hosts more refugees than any other country in the world. Incoming numbers have increased steadily since the outbreak of the Syrian war in 2011. This raises enormous challenges for the host country, not least with regard to the provision of healthcare. This article examines the developments in the light of stratified membership theories. More specifically, it asks how far the healthcare system in Turkey can be categorised as a system of stratified membership for different groups of urban refugees, focusing on refugees from Syria, Iraq and Afghanistan. Following a theoretical debate about stratification in the provision of social rights, 16 semi-structured interviews with experts and active participants were carried out in Ankara to understand the situation of urban refugees in need of healthcare. The results confirm assumptions of stratified membership theories which understand citizenship in a broad sense as comprising the interconnected dynamics between social rights, legal status and identity requirements. Next to ethnic categories of origin defining the status in Turkey, factors such as language skills or the individual economic situation also play crucial roles for stratified membership both as an empirical fact and as a constructed practice.

Summary: China's population is aging rapidly, while the traditional long‐term care (LTC) system that heavily relies on families is eroding. In response, China has embarked on a journey of policy experimentation for long‐term care insurance (LTCI) since 2016, launching LTCI pilots in 15 pioneer cities. These pilots have a great diversity in participation, eligibility, and provision. This paper estimates the prevalence of LTC needs and analyzes the impact of the LTCI pilots on access. Although substantial progress has been achieved, the overall coverage of LTCI is still relatively small, and a large proportion of vulnerable people needing LTC seem to be left behind because of the strict eligibility criteria. This analysis suggests that future policy experimentation on LTCI reform in China needs to address the following pressing policy issues: expanding the coverage of LTCI; narrowing rural–urban disparities in access; improving access for vulnerable subpopulations; and reducing the heavy reliance on institutional care.

Summary Background Addressing the growing burden of mental diseases is a public health priority. Nevertheless, many countries lack reliable estimates of the proportion of the population affected, which are crucial for health and social policy planning. This study aimed to collect existing evidence on the prevalence of mental diseases in Austria. Methods A systematic review was conducted using MeSH, EMTREE and free-text terms in seven bibliographic databases. In addition, the references of included papers and relevant Austria-specific websites were searched. Articles published after 1996 pertaining to the Austrian adult population and presenting prevalence data for mental diseases were included in the analysis. Results A total of 2612 records were identified in the database search, 19 of which were included in the analysis, 13 were community-based studies and 6 examined institutionalized populations. Sample sizes ranged from 200 to 15,474. The evidence was centered around depression (n = 6, 32%), eating disorders (n = 4, 21%) and alcohol dependence (n = 3, 16%). While most studies (n = 10, 53%) used questionnaires and scales to identify mental diseases, seven studies used structured clinical interviews, and two studies examined use of psychotropic drugs. Due to the diversity of methodologies, no statistical pooling of prevalence estimates was possible. Conclusion Information on the prevalence of mental diseases in Austria is limited and comparability between studies is restricted. A variety of diagnostic instruments, targeted populations and investigated diseases contribute to discrepancies in the prevalence rates. A systematic, large-scale study on the prevalence of mental diseases in Austria is needed for comprehensive and robust epidemiological evidence.