Method for the development of national health care guidelines in Austria

Context: In Austria there are two main sources of law concerning quality in health system: the ‘Gesundheitsqualitätsgesetz’ (health quality law) and the so-called ‘Vereinbarung gemäß Artikel 15a B-VG’ (agreement according to article 15a of the Federal Constitution) which regulates organisation and financing of the health care system. Both postulate transsectoral, transdisciplinal and evidence-based health care although there is no systematic approach for putting this aim into practice yet. Purpose: A national strategy for guideline development shall be designed and published as an own guideline, the so-called ‘MetaLeitlinie’. This consistent method assures that international accepted rules of guideline development as well as national boundaries, such as legal aspects and practice of health care delivery are considered in future guideline development. Description: To follow the principle of transsectoral and transdisciplinal guidelines an expert panel, consisting of main stakeholders of health care system as well as representatives of health professionals and patients, guides the whole development process and assures consensual and accepted outcomes. As this approach is novel, the whole process is proposed as work in progress. Conclusions: Experiences of the current development of national health care guidelines are integrated in the development of the ‘MetaLeitlinie’ and lead to the fact that both development processes influence each other. The practical guideline development provides the opportunity to learn from the practice while defining the methodical framework. The first draft of the guideline is expected to undergo a national public consultation process in Summer 2009 and shall be discussed with some international experts until the end of 2009. Discussion: Development and implementation of a national framework for guideline development in health care system is a great challenge and means the integration of different perceptions and requirements. The chosen way of integrating evidence and expertise as well as learning from practical guideline development work is challenging but seams to assure acceptance and practicability of the final results.