The Scarring Effect of the 2008 Economic Crisis: Growth and Growth Decline in Austria’s Nonprofit Social Services Sector

Since the 2008 economic crisis, social service providers worldwide have reported funding cuts, while the need for some social services has been increasing. This paper examines the combined and longer-term effects of such divergent developments on the nonprofit social services sector. The empirical analysis uses Austrian administrative data on six subfields of the sector covering the years 2003–2017. We investigate significant changes in the trends of four growth indicators applying interrupted time series analysis. We find that the 2008 economic crisis is associated with persistently lower growth rates in Austria’s nonprofit social services sector. The magnitude of this dampening effect differs across subsectors. Additionally, our findings suggest an increase in market concentration. Hence, the study discloses a long-term scarring effect of the economic crisis on Austria’s social services sector, raising doubts on the sector’s future resilience

Gradient-prolongation commutativity and graph theory

This Note gives conditions that must be imposed to algebraic multilevel discretizations involving at the same time nodal and edge elements so that a gradient-prolongation commutativity condition will be satisfied; this condition is very important, since it characterizes the gradients of coarse nodal functions in the coarse edge function space. They will be expressed using graph theory and they provide techniques to compute approximation bases at each level.Comment: 6 page

Nonprofit Organisationen in Österreich 2014

Series: Forschungsberichte / Institut für Sozialpoliti

Low-, moderate-, and high-risk obesity in association with cost drivers, costs over the lifecycle, and life expectancy

Background: The prevalence of low-, moderate-, and high-risk obesity has been increasing globally. Our aim was to estimate the societal burden of these three obesity classes in the Austrian population by taking a societal–annual perspective and an individual–life-cycle perspective. Secondly, we sought to identify the respective cost drivers and the effects on life expectancy. Methods: We used population-weighted survey data on the distribution of body mass index (BMI) and data on relative risks regarding 83 diseases. Using fractional polynomial regressions, we estimated relative risks per BMI unit for about 30 cost-intensive diseases up to BMI values of 50. The approach for the cost analysis was based on the use of population-attributable fractions applied to direct medical and indirect cost data. Macro-disease-specific data regarding cost factors came from cost-of-illness statistics and administrative sources. Results: About 8.2% of deaths and 4.6% of health expenditure are attributable to obesity in Austria in 2019, causing 0.61% of GDP loss. A third of annual direct and indirect costs came from class 2 and class 3 obesity. From an individual perspective, life-cycle costs of class 2 and class 3 obesity were 1.9 and 3.6 times the costs of class 1 obesity, respectively. At the age of 45, people with high-risk obesity are about to lose approximately 4.9 life years and 9.7 quality-adjusted life years. Conclusions: We have extended the method of population-attributable fractions, allowing us to estimate differences in the life-cycle direct medical and indirect costs between low-, moderate-, and high-risk obesity. We found that the lifetime costs of obesity are strikingly different between obesity classes, which has been veiled in the societal—annual perspective. Our findings provide a foundation for evaluating public health interventions aimed at combating obesity in order to mitigate the escalating individual and societal burden resulting from obesity prevalence and complications in the future

Costs attributable to hypercholesterolemia in a single period and over the life cycle

Hypercholesterolemia is a major risk factor for atherosclerotic cardiovascular disease leading to reduced (healthy) life years. The aim of this study is to quantify the societal costs associated with hypercholesterolemia. We use epidemiologic data on the distribution of cholesterol levels as well as data on relative risks regarding ischemic heart disease, stroke, and other cardiovascular diseases. The analytical approach is based on the use of population-attributable fractions applied to direct medical, direct non-medical and indirect costs using data of Austria. Within a life-cycle analysis we sum up the costs of hypercholesterolemia for the population of 2019 and, thus, consider future morbidity and mortality effects on this population. Epidemiologic data suggest that approximately half of Austria’s population have low-density lipoprotein cholesterol (LDL-C) levels above the target levels (i.e., are exposed to increased risk). We estimate that 8.2% of deaths are attributable to hypercholesterolemia. Total costs amount to about 0.33% of GDP in the single-period view. In the life-cycle perspective, total costs amount to €806.06 million, €312.1 million of which are medical costs, and about €494 million arise due to production loss associated with hypercholesterolemia. The study points out that significant shares of deaths, entries into disability pension and care allowance, full-time equivalents lost to the labor market as well as monetary costs for the health system and the society could be avoided if LDL-C-levels of the population were reduced

The size–growth relationship in the social services sector in Austria

The social services sector is among the fastest-growing industries, but it has gained little attention in the debate regarding frm growth. This article analyzes frm growth in relation to frm size using payroll expenses as our indicator for both frm growth and frm size. We apply structural equation modeling and full maximum likelihood estimation using Austrian data comprising all non-proft social service providers. After 2013, fewer frms have been entering and more have been exiting the sector; however, we fnd that growing in size is still not associated with higher growth rates. Our study emphasizes the role of small organizations in remaining a growth sector

Die volkswirtschaftlichen Effekte von Adipositas im Kindesalter

Im Jahr 2019/20 war in etwa jedes vierte Kind in Österreich von Übergewicht oder Adipositas betroffen (COSI, 2021). Adipositas steht im Zusammenhang mit einer Fülle an Folgeerkrankungen, einer geringeren Lebenserwartung und reduzierten Lebensqualität sowie mit Einkommensverlusten. Ziel dieser Studie war es, die volkswirtschaftlichen Effekte von Adipositas im Kindes- und Jugendalter für Österreich zu schätzen. Es wurde dabei zwischen direkten medizinischen und indirekten Kosten unterschieden. Intangible Kosten wie psychische Belastungen durch Stigmatisierung und Diskriminierung wurden nicht quantifiziert, da es sich hier per definitionem um Kosten handelt, die schwer in monetäre Werte zu fassen sind. Kosten wurden für das Jahr 2019 berechnet sowie die Summe an Kosten über den gesamten Lebenszyklus – pro Person und als Summe aller Geburtenkohorten der Jahre 2000 bis 2019. In Austria, nearly every fourth child is affected by overweight or obesity as of 2020. These children are at high risk to continue to be affected by obesity over their lives. Obesity reduces a child’s health-related quality of life, affects a child’s school career – and, with it, their future income – and leads to a variety of diseases and lower life expectancy. This study estimates the economic effects resulting from childhood obesity for Austria. The analysis includes direct medical and indirect costs; costs are calculated for the year 2019 and over the entire life cycle. The study uses obesity prevalence based on measurement data from the Austrian COSI (2021) study, from Austrian candidates for conscription (2022), as well as the German KIGGS study (2018) for children up to four years. Based on prevalence data and data on relative risks for obesity-associated health problems in children and adults, we estimate population-attributable fractions applied to diagnosis-specific average per-capita health expenditure (excluding long-term care). Indirect costs arise from income losses due to sick leave, disability, and premature mortality, as well as from a proportional income loss associated with the choice of school, the choice of profession and discrimination in the labour market. The life-cycle model includes all secondary diseases in adult life. It also considers a discount rate of 3 percent, obesity-associated mortality, and future increases in health care costs. To estimate medical and indirect costs for all birth cohorts from 2000 to 2019, we use a forecast of obesity prevalence among 20- to 24-year-olds in Austria up to the year 2039. Based on results from international long-term studies, we assume that about half of the 20- to 24-year-old population with obesity has a history of obesity during childhood or adolescence. The resulting sum of annual costs of childhood obesity is € 12 million in 2019. Average annual costs for a child with obesity are around € 100 higher than for a child without obesity (€ 120 for adolescents). The life-cycle medical costs largely depend on the degree of obesity: for a man with obesity class I, class II, or class III total medical costs amount to around € 21 000, € 44 000, and € 68 000, respectively. For women, the corresponding values are € 21 000, € 32 000, and € 48 000. Total loss of productivity is approx. € 130 000 and € 88 000 for men and women, respectively (assuming a 10 percent penalty on wages). Finally, we estimate that around 95 000 of all children and adolescents in 2019 will enter young adulthood with obesity, which leads to a cash value of € 8.85 billion or an annuity of € 280 million in total costs. In conclusion, this study shines light on the considerable economic burden of childhood obesity in Austria. In addition, children with obesity often deal with a mental burden caused by stigmatisation and discrimination. Public health programs addressing obesity could relieve high costs not only for individuals, but also for society as a whole

Impact of national-scale targeted point-of-care symptomatic lateral flow testing on trends in COVID-19 infections and hospitalisations during the second epidemic wave in Austria

Background: In October 2020, amidst the second COVID-19 epidemic wave and before the second-national lockdown, Austria introduced a policy of population-wide point-of-care lateral flow antigen testing (POC-LFT). This study explores the impact of this policy by quantifying the association between trends in POC-LFT-activity with trends in PCR-positivity (as a proxy for symptomatic infection) and hospitalisations related to COVID-19 between October 22 and December 06, 2020. Methods: We stratified 94 Austrian districts according to POC-LFT-activity (number of POC-LFTs performed per 100,000 inhabitants over the study period), into three population cohorts: (i) high(N=24), (ii) medium(N=45) and (iii) low(N=25). Across the cohorts we a) compared trends in POC-LFT-activity with PCR-positivity and hospital admissions; and, b) compared the epidemic growth rate before and after the epidemic peak. Results: The trend in POC-LFT activity was similar to PCR-positivity and hospitalisations trends across high, medium and low POCLFT activity cohorts. Compared to the low POC-LFT-activity cohort, the high-activity cohort had steeper pre-peak daily increase in PCR-positivity (2.24 more cases per day, per district and per 100,000 inhabitants; 95% CI: 2.0-2.7; p<0.001) and hospitalisations (0.10; 95% CI: 0.02, 0.18; p<0.15), and 6 days earlier peak of PCR-positivity. The high-activity cohort also had steeper daily reduction in the post-peak trend in PCR-positivity (-3.6; 95% CI: -4.8, -2.3; p<0.001) and hospitalisations (-0.2; 95% CI: -0.32, -0.08; p<0.05). Conclusions: High POC-LFT-use was associated with increased and earlier case finding during the second Austrian COVID-19 epidemic wave, and early and significant reduction in cases and hospitalisations during the second national lockdown. A national policy promoting symptomatic POC-LFT in primary care, can capture trends in PCR-positivity and hospitalisations. Symptomatic POC-LFT delivered at scale and combined with immediate self-quarantining and contact tracing can thus be a proxy for epidemic status, and hence a useful tool that can replace large-scale PCR testing

Status quo und Ausblick: Gesundheitsdaten von Kindern und Jugendlichen in Österreich

Diese Ausgabe des HSW bietet einen Überblick zu bestehenden und fehlenden Gesundheitsdaten von Kindern und Jugendlichen in Österreich mit besonderem Augenmerk auf die Erhebungsmethoden und bietet eine Diskussionsgrundlage für weitere Schritte hinsichtlich der Verbesserung der Gesundheitsdaten dieser Zielgruppe

Effects from treating moderate- to high-risk obesity patients with anti-obesity medication from a societal perspective

Obesity is a global health concern with new medication treatment options. So far, research on how programs with newer anti-obesity medication (AOM) for the moderate- to high-risk population can mitigate the prevalence of obesity and reduce the economic burden of society is limited. We aimed to assess such impacts of AOM and lifestyle intervention with the GLP-1 receptor agonist semaglutide on patients with different obesity classes, i.e. risks (and no diabetes), based on clinical trial data. We estimated the treatment effect on prevalence, medical and indirect costs using the population-attributable fraction approach and various data sources. We modified prevalence data from the Austrian Health Interview Survey 2019 (n = 15,461) using data about proportional weight reductions after the treatment with semaglutide as an adjunct to lifestyle intervention. In a life-cycle model, we compared the costs of obesity classes. Treating 50% of patients with obesity class II and III (excl. diabetes patients, including patients not responding to the treatment) over 68 weeks, reduced the prevalence from 4% to 2.74% (95% CI 2.739–2.743) and from 1.45% to 0.97% (95% CI 0.969–0.997), respectively. This resulted in a reduction of 12.9% (€ − 108.7 million) of expenses related to obesity class II and III per year. Over the life cycle, a reduction in obesity class reduced costs by about 40% per patient. The newer AOM can aid in reducing moderate- and high-risk obesity rates and bring economic and health benefits to society, given that AOM are available and affordable for the respective populations