This chapter focuses on the role of workplace practices for enabling employee transitions in the mid-career and longer working lives in Austria. The chapter first discusses support programmes for companies to develop age‑appropriate workplaces. The chapter then looks at the central role of mid-career reviews and career guidance to enable mid-career mobility. Finally, the chapter focuses on health at work as a key area for age management in the workplace. This includes both investment in workplace health prevention measures and early intervention measures in the case of sickness absence to enable return to work.
Promoting Better Career Mobility for Longer Working Lives in Austria
Abstract
Key messages
Workplace practices play a key role in facilitating longer and healthier working lives. Age‑appropriate management practices include policies to facilitate employee transitions to different roles or different tasks, where appropriate, as well as broader measures for creating a safe and healthy working environment which also acknowledges the value of a good work-life balance.
In Austria, several company consulting programmes support employers in developing and implementing practices for age‑appropriate workplaces. The Public Employment Service (PES) offers consultation on personnel management processes, including age management, through its Impulse Consulting Programme. Meanwhile, Demographic Consulting Digi+ offers consulting with special emphasis on age management in the context of digitalisation. These programmes focus on elements such as hiring processes, job and workplace redesign and training. Several evaluations have shown that company consulting has a positive impact on workplace practices.
Despite active dissemination efforts, the reach of company consulting remains limited. While the effects of consulting and management support are positive, it reaches only a fraction of companies in the Austrian labour market. The PES and other providers implement outreach and dissemination activities to increase the reach of the programmes.
Mid-career reviews are one key workplace practice for managing employee transitions, but this practice is not common in Austria. Mid-career reviews are a joint reflection between employer and employee towards the middle of the career to plan for the next stages. Reflections from stakeholders and some pilot programmes indicate that there is interest from employees in such mid-career support.
Mid-career guidance outside of the workplace can play an important role in enabling transitions not linked to current employment. A system for providing such guidance does not exist in Austria. While the PES provides career guidance, its services are largely targeted at the unemployed. An educational counselling service under provincial authority provides guidance on education and training, but it is not specifically targeted at mid-career workers and participation sharply declines after age 45.
Health at work is another key area of interest for age management in the workplace. Recently, Austria has taken steps to increase co‑ordination in this area through the National Strategy on Health at Work, which considers both prevention and return‑to‑work elements. However, the policy landscape at the intersection of health and work remains complex and difficult to parse, and available data is patchy.
Investment in health prevention in the workplace is paramount for enabling longer and healthier working lives. While the presence of most health risk factors in the workplace has decreased over time in Austria, concerns remain, particularly with regard to psychosocial risk management. Companies are still much less likely to consult psychologists than other experts as part of health and safety services.
Despite improvements, a co‑ordinated, systematic procedure for return to work after illness is still not in place in Austria. The introduction of fit2work, which offers information and counselling on work-related health issues and return to work, is a step forward. Evaluations have shown positive effects of fit2work on return to employment. However, participation is entirely voluntary and take‑up is significantly skewed towards already unemployed individuals. Workers on sick leave needing support should be identified systematically and consulted much earlier. In addition, fit2work offers consultation for companies on health management in the workplace and return to work, but participation is skewed towards companies who already perform well in this regard and evaluations show only limited effects.
Disability benefit reform in 2014 aimed to increase participation in rehabilitation measures and return to employment, but this was largely unsuccessful. Data shows that most disability benefit applicants and recipients never return to work again. This is partly related to co‑ordination problems between the different systems and institutions involved. However, most individuals who claim disability benefit are already so far removed from the labour market that intervention comes too late to realistically enable a return to employment. This underlines the need for earlier intervention.
Based on these considerations, Austria should consider taking action to:
1. Scale up company consulting programmes. This includes increased funding for consulting itself and increased investment in outreach and communication to increase coverage.
2. Encourage social partners to promote age‑appropriate workplace practices more strongly, as part of their negotiations. Social partners could strengthen their dissemination activities on age management in the workplace. In addition, age management could be included in collective bargaining agreements, following examples from Germany.
3. Promote mid-career reviews as a good workplace practice. Promoting this should include implementation guidance and support for companies, for instance through company consulting.
4. Develop a system for external mid-career guidance. This should be specifically targeted at mid-career workers and provide holistic counselling on planning for the rest of the career. One pathway for implementation would be through the educational counselling system, with the advantage of building on an existing regional infrastructure.
5. Carefully monitor progress of the Austrian strategy on health at work. This should include investment in improved data collection on health management at company level.
6. Consider introducing further public funding and support for increased health prevention in the workplace. Guidance for companies on workplace health promotion should be developed and disseminated, with particular attention to psychosocial risks. Policymakers may consider introducing financial incentives for health promotion, such as insurance‑based incentives or tax credits, but these need to be carefully designed.
7. Move towards a structured, mandatory early intervention and case management system for return to work. Individuals at risk of labour market exit need to be identified early and contacted proactively. Both the health insurance and the pension insurance could reach out to employers to identify workers at risk early and promote early intervention. A monitoring and case management system for return to work with clearly defined timelines and obligations should be introduced, involving all key institutions as well as the employer and the worker.
8. Strengthen fit2work as part of the improved early intervention infrastructure. This could include making part of the fit2work process mandatory. In addition, the employer service of fit2work should be strengthened to help with early identification and support provision.
Company-level practices and policies can be key enablers to manage demographic change processes in the workplace and assist employees in job transitions in the mid-career. In Austria, awareness of the need to address challenges associated with ageing in the workplace is increasing among companies, particularly in the context of growing labour shortages. As a result, there is growing interest in creating age(ing)-appropriate workplaces (Box 2.1).
The academic and policy literature in the German-speaking world draws a distinction between age‑appropriate (altersgerecht) and ageing-appropriate (alternsgerecht) work.
Age‑appropriate work refers to measures that specifically address the needs of older workers and is focused on compensatory approaches (Frerichs, 2015[1]). Measures for age-appropriate workplaces include workplace redesign and adaptation, working time flexibility and job redesign (Tullius et al., 2012[2]). In contrast, measures for ageing-appropriate work seek to frame demographic change in the workplace around a life course perspective, which concerns all generations of workers and focuses on preventative measures (Frerichs, 2015[1]). A reduction in productivity at older ages is understood not only as a result of ageing, but also the social and working environment throughout the life course, and thus requires the introduction of measures to preserve employability and capacity to work at all ages (Frerichs, 2015[1]). Holistic management of demographic change in the workplace is then a combination of both age-appropriate and ageing-appropriate measures (i.e. age(ing)-appropriate or alter(n)sgerecht).
2.1.1. Company consulting programmes can enable employers to drive forward age management in the workplace
Many companies, particularly SMEs, require support and consultation in the development of age management practices in the workplace. In Austria, several programmes that provide such support have been introduced in recent years.
Impulse Consulting for Companies helps employers in strategic personnel management
As part of the services it offers to companies, the Austrian Public Employment Service (Arbeitsmarktservice, hereafter referred to as PES, Box 2.2) offers free consulting for Austrian companies of all sizes, first introduced in 2015. The aim of the “Impulse Consulting for Companies” (Impulsberatung für Betriebe) programme is to assist companies with challenges related to personnel management. There are seven potential areas of focus for consulting services, one of which is the creation of age(ing)-appropriate workplaces.1 Consulting services are contracted out to external consultants by the PES. The consultation consists of a four‑stage process, including an initial consultation, a needs analysis, a consultation based on the focus area chosen, and a follow-up after three to six months.
The Labour Market Service (Arbeitsmarktservice or AMS) is the Austrian Public Employment Service. Its primary mandate is to intermediate between jobseekers and vacancies. It provides support for companies and the unemployed in the form of consultation, information, qualification and financial subsidies. In addition, the PES is responsible for the payment of various benefits, including unemployment benefit. The tasks of the PES also include the issuance of work permits for third-country nationals and expert reports for the red-white‑red card, the EU blue card and EU posting confirmations.
In 1994, the PES was organisationally separated from the Federal Ministry for Labour. However, PES activities are guided by the labour market policy goals, which are set every year by the Ministry of Labour and Economy.
The PES has a regionalised structure. In addition to the federal head office, it has offices in all nine Austrian provinces as well as 99 regional branch offices. At each level, the social partners are involved in the organisation and monitoring of PES activities.
Up to May 2023, 7 218 companies had participated in a first consultation through the program, of which 2 539 (35.2%) proceeded to an in-depth subject specific consultation (Endel et al., 2023[3]). Out of these 2 539 companies, 16.9% selected age(ing)-appropriate workplaces as their area of focus (Ibid.). Table 2.1 presents data on the characteristics of all participating companies. A rather large share (74%) of participating entities are small companies. Participating companies tend to have a high share of employees aged 45 or older (30% or more in 66.1% of companies), and a low share of low-paid and low-qualified workers.
Impulse consulting for companies in the area of age(ing)-appropriate workplaces can focus on age‑specific hiring practices, redesign of jobs and workplaces, working time policies, intergenerational knowledge transfer, health management practices and training measures. Case study examples of changes implemented in companies after consulting include reducing working time for older employees to facilitate gradual retirement and longer retention in the company; developing processes for long-term personnel planning (including at the management level); improving recruitment practices to attract more diverse personnel; establishing practices for more flexible working; mapping job tasks across employees and identifying potential for reallocation to make work less arduous for (older) employees.
A recent evaluation of the programme demonstrates that the consulting service is associated with changes in HR practices in participating companies (Endel et al., 2023[3]). Relative to a control group, these companies were relatively more likely to hire low-qualified workers, women, and workers over the age of 45, with the share of companies hiring older workers being 5 percentage points higher than in the control group. In addition, participating companies also had more contact with PES (posting vacancies through the PES or using PES services or subsidies). The effect of the programme was largest in small and, particularly, micro companies.
Characteristics of Austrian companies participating in PES company consulting, up to May 2023
PES: Public Employment Service.
Note: Low-paid employees are defined as those with a standardised monthly income below 1.5 times the minimum income. Company growth refers to development of company size relative to previous year.
Source: Authors’ calculations based on Endel et al. (2023[3]), “Impulsberatung für Betriebe: Monitoring und Resonanzanalyse”, Jahresbericht 2023 des Projekts »Wirkungsmonitoring Impulsprogramm«, Synthesis Forschung, Vienna.
Demographic Consulting assists companies in dealing with demographic change
Alongside the PES company consulting, a further significant initiative in the realm of company consulting is “Demographic Consulting” (Demografieberatung). Co-financed through the European Social Fund Plus (ESF+), demographic consulting is a more in-depth, long-term instrument for consultation and accompaniment of companies, with a specific focus on demographic change. In the first programming period (2017‑22), a budget of ca. EUR 25 million was allocated for the measure. In total, 1 814 companies participated in the program, 90% of which were SMEs and 39.7% of which had fewer than 15 employees (Demografieberatung, 2022[4]). In the second programming period (2023‑27), the programme has been rebranded as Demografieberatung Digi+ and will more specifically focus on digitalisation as a specific challenge within the context of age(ing)-appropriate workplaces. A budget of ca. EUR 17.6 million is foreseen for programme implementation, meaning that approximately 930 companies will be reached. Companies are actively contacted by the consultancies implementing the project, with a specific focus placed on reaching smaller companies and sectors in need.
The consulting process seeks to help companies manage challenges associated with demographic change in the workplace. This involves an in-depth multi-step consultation, free of charge for companies. Consultation steps include an initial needs analysis, the development of an in-depth analysis and company-specific measures, an accompaniment during measure implementation, and a follow-up with potential additional consultation six months after the end of the process. Consultation focuses on five thematic areas, depending on company needs: work design, leading and culture, personnel management, knowledge and competences and health.
Both stakeholders and existing research evaluate the Demografieberatung as a highly effective initiative for the development of company-level practices to deal with demographic change in the workplace. In interviews with stakeholders involved in the management and implementation of the programme (Lutz et al., 2019[5]) several factors were highlighted as facilitators: the high level of qualification and experience of implementing consultants, the support of key stakeholders, the incorporation of outreach and publicity activities as part of the project, and the inclusion of accompaniment throughout implementation in the process, among other factors (Lutz et al., 2019[5]). Follow-up data collected from participating companies also shows high levels of satisfaction with the programme (Table 2.2). Six months after completion of all steps involved, participating companies indicated significant improvements in three target dimensions – conditions for age(ing)-appropriate work, redesign of jobs and workplaces, and long-term health conservation. The demographic consulting programme also demonstrates relatively high retention rates. In the 2017‑22 period, 58.6% of companies completed all steps (Demografieberatung, 2022[4]). The majority of dropouts occurred in the initial consultation phase, where 26% of companies decide not to proceed with the programme (Ibid.).
Evaluation of three target dimensions by companies participating in Demographic Consulting, (percentages)
Note: Companies surveyed May 2019‑June 2021, ca. six months post-consultation. Based on Demographic Consulting Follow-Up Check.
Source: Lutz et al. (2019[5]), “Das Operationelle Programm “Beschäftigung Österreich 2014 bis 2020” des Europäischen Sozialfonds. Endbericht der begleitenden Evaluierung”, Österreichisches Institut für Wirtschaftsforschung; Institut für Höhere Studien; L&R Sozialforschung, Vienna.
The NESTORGOLD quality label for age(ing)-appropriate organisational structures
NESTORGOLD is a quality label for companies, awarded by the Ministry of Social Affairs, Health, Care and Consumer Protection. The initiative aims to recognise companies whose organisational structure is designed in an ageing-appropriate, generationally appropriate and gender-appropriate way. In doing so, it seeks to strengthen awareness of the importance and value of generational management in the workplace and ultimately increase the motivation and ability of all workers to work until pension age. NESTORGOLD assessment takes a holistic approach and is based on qualitative indicators in four thematic fields (Box 2.3). The programme is small in scale – up to July 2024, 30 companies had successfully received the quality label – but serves to raise awareness of the importance of age‑appropriate workplaces among companies.
NESTORGOLD assessment is based on four qualitative fields, with the aim of a holistic assessment of intergenerational management in the workplace. For each thematic field, indicators are developed by the NESTORGOLD board and used in assessment. These qualitative indicators capture the practices and processes present in workplaces related to intergenerational management.
Individual. This element emphasises the joint responsibility of company management and employees for the development and ability to work of each individual. This includes topics such as autonomous work, willingness to participate in further training, participation and support for the maintenance of ability to work.
Organisation. This element focuses on organisational processes for furthering dialogue between generations and ensuring the development of age(ing)-appropriate workplaces. This involves life course‑appropriate work design and working time models, systems for retaining organisational knowledge, strategic personnel development and processes for health at work and reintegration.
Culture. This element deals with organisational culture, specifically that organisational values and learning culture reflect equality of opportunity and encourage trust of employees. This is reflected in the presence of anti-discriminatory values in daily communication, active participation of all workers in the organisation, a constructive feedback culture, age‑appropriate learning opportunities and knowledge sharing across generations.
Vitality. This element emphasises the capacity of the organisation to act with a long-term perspective and use external feedback for development. This involves, for instance, long-term planning for demographic processes, measures to retain employees until pension age, and using information on customers’ needs for the development of the organisation.
To be awarded the quality label, companies undergo an in-depth evaluation process. After an initial first consultation, an overview assessment of each company is created during a status assessment workshop. If required, an action plan for the improvement of generational management in the company is subsequently developed, including key performance indicators, milestones and timeline. Measure implementation is accompanied by NESTORGOLD consultants where needed. Prior to award of the quality label, external assessment takes place, including review of company-specific data and documents and interviews with company staff. To ensure sustainability of the programme, a recertification process takes place every three years.
Insights from company consulting initiatives
Overall, there is a developed landscape of company consulting offers in Austria, designed to assist them in managing demographic change in the workplace and develop company-level policies for age(ing)-appropriate workplaces. Several evaluations have shown that company consulting has positive effects on company-level practices. These programmes are therefore a meaningful pathway for helping employers develop and implement practices to manage ageing in the workplace, including transitions of employees where needed or helpful.
However, the overall reach of company consulting programmes, particularly the most in-depth programmes such as demography consulting, remains limited, reaching only a fraction of Austrian companies. There may be room for scaling up some programmes, such as Impulse Consulting, whose overall budget for 2020‑23 constituted EUR 32.7 million. In the meantime, it is important to continue carefully targeting programmes at companies most in need, and further strengthening outreach and communication activities to reach a larger number of companies (see also section 2.1.2). In addition, synergies between the different consultation programmes could be explored to increase reach and efficiency.
2.1.2. Supporting the development of company-level practices by building networks, sharing information and raising awareness
To establish workplace practices and help employees with their professional development and potential career transitions, increasing awareness and knowledge among companies is essential. While company consulting programmes such as those described in section 2.1.1 can play an important part in this, they only reach a fraction of the overall company landscape, particularly in the case of programmes that involve an in-depth accompaniment. As such, it is important to combine these programmes with efforts to build company networks and broader awareness raising and information spreading actions, facilitated through stakeholder engagement.
Building company networks for increased outreach and information sharing
Company networks can serve as a key platform for sharing of best practices and information, particularly for SMEs. The PES hosts several types of events for companies to encourage information exchange. These include expert talks on specific topics of interest, networking events with various discussion formats that aim to connect companies and the (regional) PES, and workshops where companies can identify and develop concrete actions for implementation. These events are not limited to companies participating in PES company consulting.
Other company consulting initiatives described in section 2.1.1 also include efforts to connect companies. Within the demography consulting programme, publicity and outreach activities have received specific attention. This led to the development of “active ageing circles”, regular fora for exchange among companies and other stakeholders, with different formats depending on company-specific needs (Demografieberatung, 2022[4]). The explicit aim of these networking efforts is to ensure sustainability of the programme beyond the actual consultation process. Events for information sharing are also regularly held as part of the NESTORGOLD programme. These include practical workshops where organisations present their experience and best-practice initiatives and networking dialogues where experts in the area of generational management in the workplace present strategies and solutions.
In addition, building company networks at provincial level can be a promising approach. For example, in Upper Austria, the WAGE‑Network provides a space for developing solutions related to ageing in the workplace among companies and other key labour market actors. Approximately 90 companies are currently part of the network. WAGE serves as a platform for sharing resources and knowledge around the topic and organises workshops for member companies. It also enables direct contact with key regional labour market actors, such as regional PES and social partners, and therefore concrete links to subsidies or other supporting initiatives.
Increasing social partner involvement and support
Social partners are key stakeholders within the Austrian labour market policy landscape and could play a critical role in disseminating information and increasing awareness among companies. The Work&Age (Arbeit&Alter) website2 is a joint initiative by Austrian trade unions and employer organisations. The website serves as an information point for companies on age(ing)-appropriate workplace. It collects best practice examples from Austrian companies and provides guidance on how companies can implement workplace practices that respond to demographic change management.
However, social partners could become even more active in supporting and shaping the creation of age(ing)-appropriate workplaces. On the one hand, social partners could more actively disseminate information on resources and programmes for companies, such as company consultation. On the other hand, beyond dissemination activities, age management in the workplace could play a more prominent role in social partners’ collective bargaining agreements. Examples of sectoral collective bargaining agreements on demographic change in Germany showcase how such agreements can effectively create awareness and impulses for action within companies (Box 2.4).
In Germany, the practice of collective bargaining agreements focused on demographic change (so-called demography agreements) has become increasingly established, with agreements in sectors, such as iron and steel, and chemicals and pharma (INQA, 2011[6]). This reflects a growing orientation of trade unions towards promoting industry wide framework conditions that regulate demographic challenges (Naegele and Hess, 2018[7]). The agreement in the chemicals industry, agreed in 2008 and updated in 2015, was the first sectoral agreement explicitly addressing demographic change at national level. The collective agreement includes three central elements: (i) a “demography analysis” of personnel structure to be undertaken in all companies on a regular basis (ii) the joint elaboration of measures for age(ing) appropriate workplaces at company level (iii) the creation of a “demography fund”. Employers pay EUR 750 per year into the fund for each employee, which can be used to fund education and training, partial retirement, working time reduction or health prevention measures, based on company-level negotiations (BAVC, 2021[8]).
A greater involvement of social partners in age management processes through collective bargaining can contribute to increased awareness of the issue among employers and works councils and create impulses for the development of concrete measures at company level (Frerichs, 2015[1]; Katenkamp, Martens and Georg, 2012[9]). While the agreement in the chemical sector, for instance, leaves company-level actors a lot of flexibility in choosing specific measures, the compulsory elements – the demography analysis and payment into the demography fund – mean that resources and effort are directed towards the issue (Tullius et al., 2012[2]). The demography analysis has been shown to significantly increase awareness of changes in their personnel structure among individual companies, leading to more structured engagement with the demographic change issue (Paprotny, 2016[10]; INQA, 2011[6]).
Tackling age discrimination to enable multi-generational workforces
Age discrimination remains a barrier to the successful integration of older workers in the labour market, both internationally and in Austria. A recent study conducted on behalf of the Austrian PES demonstrated that employers do discriminate against older workers in hiring (Schönherr and Bohrn, 2023[11]). Based on an experimental design using fictional job applications of workers with different characteristics, it was found that instances of discrimination against older applicants occur in 12% of companies.
Discrimination in hiring is difficult to tackle. Company consulting initiatives that deal with the management of demographic change in the workplace can certainly play a role in illustrating the value of a generationally diverse workforce to employers. Beyond these targeted interventions, with rather limited reach, broader campaigns can also play a role. The Austrian PES recently ran a large campaign, “Opening instead of closing” (Aufmachen statt Zumachen3), which aimed to encourage employers to recruit more openly, age being one of the main focal points of the campaign. The campaign highlighted cases of companies benefitting from hiring more diversely, shared information about PES support and initiatives, and included a publicity campaign (e.g. TV spots) against discrimination in hiring.
One key workplace practice for enabling mid-career transitions for workers are mid-career reviews. Giving workers the opportunity to reflect on their future career path and potential adjustments to their current work in the second half of their labour market career – including transitions into different functions or jobs – can be a key way to enable individuals to anticipate changes and ensure sustainability of employment throughout their working life. There is also room for such reflection to take place outside of the workplace. However, either way, it is not a common practice in Austria.
2.2.1. Mid-career review systems in the workplace can enable reflection and planning
Within the workplace, one tool for enabling career reflection and planning are mid-career reviews – systematic assessments of an individual’s skills and interests that allow for planning the next stages of their working life (Eurofound, 2016[12]). Through a joint reflection between employer and employee, longer-term planning is enabled and adjustments to the design of the current job or transitions within the company can be planned for, if required in order to ensure long-term employability (OECD, 2024[13]). In Austria, the practice of mid-career reviews is not common, but stakeholders appreciate that a more systematic assessment in the mid-career would be beneficial, and examples of pilot programmes appear to show that such a practice would be appreciated by workers in the mid-career. For instance, the Austrian Federal Railways (ÖBB) implemented the “pit stop” pilot programme, which focused on assessment and coaching for employees interested in career change (Box 2.5). Examples from other countries also show that mid-career review programmes are appreciated by employees and can serve as both a talent attraction and retention tool for employers (Box 2.6).
In November 2022, the ÖBB piloted the “pit stop” (Boxenstopp: Perspektive) programme for one year within one of its group companies. The aim of the pilot programme was to offer counselling services for employees who are interested in a job change and thereby ultimately limit moves out of the company.
The “pit stop” programme offered confidential and free counselling services, framed as a “prospect conversation” (Perspektivengespräch), on a voluntary basis. The counselling process included an assessment of one’s current situation at work and a discussion of possibilities for changes or adaptations. This discussion addressed different issues depending on the situation of the employee and the motivation for a job change, including for instance adaptation due to health needs or evolving skills demand.
An evaluation of the pilot programme showed that participation was relatively limited. However, employees who participated evaluated the programme positively and employees from other group companies who were not eligible for the pilot expressed interest in participating in coaching, demonstrating the demand for assistance with career development and mobility. The evaluation concluded that in case of expansion of the programme, communication efforts should be further increased with the aim of framing within-company mobility more positively.
Aviva, a major provider of saving and retirement products in the United Kingdom, implemented mid-life reviews nationwide in 2019, targeted at employees aged 45 and over. The Aviva programme focused on three areas – wealth, work and well-being. A one‑off 1.5‑hour group seminar was delivered to interested participants, after which they had the option of follow-up one‑to‑one support from a financial advisor and access to a free digital self-assessment tool. The programme aimed to enhance financial literacy and challenge the perception that career development stagnates after age 50.
The initial seminar had a 94% participation rate, signalling high demand for midlife career orientation services. Significant positive impacts have been observed. The programme emerged both as a crucial retention tool, preserving valuable skills in the organisation, and a way to attract new talent to the company.
Source: OECD (2024[14]), Career paths and engagement of mature workers, www.oecd.org/content/dam/oecd/en/topics/policy-issues/ageing-and-employment/Career-Paths-and-Engagement-of-Mature-Workers.pdf.
2.2.2. Career guidance for older workers can facilitate career transitions
In addition to mid-career reviews, which are a workplace‑level good practice, workers may also benefit from the opportunity for external counselling on their career development, which is not tied specifically to their current employment. This would allow for reflection on potential transitions out of current employment and into new, better-quality or more sustainable jobs, and the measures (e.g. training) that may be needed to enable this. Policies implemented in other countries, such as the Swiss viamia system (Box 2.7), provide some potential examples of the design of targeted mid-career guidance services.
In Austria, structured systems for career guidance targeted at mid-career workers do not yet exist. The main public provider of career counselling services is the PES, but its services are largely targeted towards unemployed individuals. Counselling accessible to everyone, independent of labour market status, is however available through the educational counselling (Bildungsberatung) programme.
Educational counselling, established in 2011, is a free service available to all adults interested in (further) education. The initiative is co‑ordinated by the Ministry for Education, Science and Research and implemented by the Austrian Länder. Counselling networks consisting of different educational counselling institutions are created at provincial level. The initiative specifically aims to reach individuals with lower access to education, with older people (50+) defined as one of the priority target groups. One of the aims of counselling is to offer individuals opportunities for job (re)orientation. Counselling services can take place either online or face‑to-face.
In 2022, 40 551 individuals participated in educational counselling across Austria. This represents a significant decrease compared to pre‑pandemic levels of participation (e.g. 101 706 in 2019) and can be related to the fact that 2022 is a “bridge year” where the project relied only on national funding, whereas it is usually partially funded by the ESF+ (Gugitscher and Lachmayr, 2023[15]). Table 2.3 shows statistics of the individuals participating in counselling activities. While the largest share of participants are employees and the programme is relatively successful at reaching groups with lower levels of education, there is a clear participation gradient by age, with a sharp decline in take‑up of educational counselling by age 45.
Since 2022, individuals aged 40+ can benefit from viamia, a free career counselling and guidance service. The aim of the programme is to improve the career prospects of individuals and address the shortage in qualified labour. After a pilot phase in 2021, the programme was rolled out nationwide.
The viamia consultation is mostly financed by the federal government (80%) and partially by the regions (20%). The programme is overseen by the State Secretariat for Education, Research and Innovation and developed by the Swiss Conference for Vocational and Educational Consultation and Career Guidance, which is responsible for the inter-regional co‑ordination of guidance services. Guidance is managed via regional representations in each region (Kanton), which interested persons can contact to make an appointment. Viamia is open to individuals who are not entitled to similar services through the PES or other institutions. The process involves an assessment of an individual’s current labour market situation, their skills and competences and their potential future development, also considering labour market trends in their sector.
In 2022 and 2023, 13 169 individuals participated in viamia counselling. A recent evaluation of the programme pointed to high levels of satisfaction with the programme and effects on participants’ willingness to participate in training and reorient themselves at work, as well as their ability to take on new tasks at work (Ecoplan, 2024[16]). Sixty percent of participants indicate that they would not have participated in career counselling without the programme. However, a disproportionately large share of participants was high-qualified and had high levels of employability. Promotional measures targeted at low-qualified workers were implemented, but reaching this group remained a challenge throughout programme implementation.
Educational counselling is a regionally designed program. Within each province, a network of institutions offering counselling is created. The number of institutions varies strongly across provinces and heterogeneity in the design and focus of the educational counselling offer seems to be rather pronounced. Data on participation in educational counselling also provide evidence of variation by province (Gugitscher and Lachmayr, 2023[15]).
A follow-up survey of participants three months after participation in the programme (Mayerl and Gugitscher, 2021[17]) indicates that counselling has positive effects on participants, though this evaluation cannot be considered representative. Participants indicate that counselling helped them feel better informed and motivated. Three months after participation, respondents report that they feel their career prospects and situation at work have improved. Participation in training has also increased, though it should be noted that participants in counselling have a higher education and training participation rate than the overall Austrian population from the outset, pointing to selection into the program. Overall, the evaluation concludes that educational counselling helps to improve career management skills, including the ability to design one’s career over the life course, to reflect on competences and interests and define and pursue goals.
One avenue for establishing a mid-career guidance system in Austria would be via the educational counselling route. This would be similar to the Swiss viamia system (Box 2.7), which is also co‑ordinated by the Ministry of Education and established via the regions. To date, the Austrian educational counselling programme has not been successful at reaching workers of older age. By developing an offer for career guidance that is explicitly targeted at mid-career workers, this issue could be addressed. More fundamentally, inter-provincial co‑ordination of the educational counselling programmes should be strengthened further to make the counselling landscape more transparent for users and ensure quality and content of counselling (see Chapter 3).
Characteristics of educational counselling participants in Austria, 2022
Source: Gugitscher and Lachmayr (2023[15]), “Bildungsberatung 2022: Gesamtjahresauswertung der gemeldeten Beratungskontakte [Educational counselling 2022: Full-year evaluation of reported counselling contacts]”, Österreichisches Institut für Berufsbildungsforschung, Wien.
With increasing age, workers are more likely to face health issues that can impede them from working. Focusing on preventive measures by strengthening occupational health policies can address the problem at the source, by enabling workers to stay in their current job for longer in good health (OECD, 2024[13]). In addition, policy plays a key role in enabling reintegration into employment after sickness absence, which can entail transitions into new types of tasks or jobs. Policies on sickness absence management and return to work have traditionally been significantly underdeveloped in Austria. At the same time, employers are allowed to dismiss employees while they are on sick leave (OECD, 2015[18]). In this context, further development of policies in this area is of key importance.
2.3.1. The intersection between health and work in Austria
In comparison with other European countries, sickness absence rates in Austria rank in the mid-field (Figure 2.1). In 2023, an estimated 3% of full-time employees were absent due to sickness. Across countries, sickness absence rates range from 8% in Norway to 0.2% in Greece.
Share of full-time employees absent due to sickness, 2023
Note: Estimates adjusted for an underestimation of 50% of sickness absences reported in labour force surveys compared with those from Health Surveys and other sources.
Source: OECD calculations based on European labour force survey (EU-LFS) data.
According to data from Austrian administrative records, the overall rate of sickness absence (days of sickness absence relative to total working time) was 4.2% in 2023; in other words, 4.2% of working time was lost to illness (Mayrhuber, Bittschi and Böhs, 2024[19]). Austrian data also sheds light on the incidence of sickness absence across age groups (Figure 2.2). Rates of sickness absence are slightly U-shaped but increase sharply from age 50, reaching a peak in the age group 60‑64 (Panel A). While older workers tend to experience fewer instances of sickness absence than younger workers, the average duration of sickness absence steadily increases with age (Panel B). These numbers highlight the importance of policies for occupational health management, including both preventative and reintegration measures, for mid-career and older workers in particular.
Note: Sickness absence rate refers to days of sickness absence relative to total working time.
Source: Mayrhuber, Bittschi and Böhs (2024[19]), Fehlzeitenreport 2024. Krankheits- und unfallbedingte Fehlzeiten in Österreich. Gesundheitszustand von Lehrlingen und jungen Erwerbstätigen [Absenteeism Report 2024: Sickness and accident-related absences in Austria. Health status of apprentices and young workers], Wien, Österreichisches Institut für Wirtschaftsforschung.
Austrian policy on health at work has historically been characterised by a fragmented institutional landscape, with competences for different elements assigned to a range of different actors (Box 2.8) and no coherent strategy for occupational health policy (Eppel, Leoni and Mahringer, 2016[20]). Funding is available through various national and regional sources, and data on overall funds for occupational health management are difficult to obtain due to the complexity of the structures. Data from 2016 suggests that ca. EUR 118 million were allocated towards occupational health management across the various actors and policy areas, excluding labour inspections – which can be contrasted with an estimated EUR 9.9 billion in estimated costs of work-related health costs in 2015 (Langmann, Kvas and Breil, 2023[21]; Leoni, Brunner and Mayrhuber, 2020[22]). These numbers suggest that there is room for further public funding for occupational health management.
The Austrian policy landscape for health at work is rather complex and a multiplicity of actors are involved at different points in the system. With regard to both prevention measures and return to work, competences are spread across a variety of actors. In addition to the responsible ministries and social partners, some of the key actors include:
Labour Inspectorate. The labour inspectorate is responsible for the enforcement of regulations on occupational health and safety. They conduct regular inspections in Austrian companies and also provide advice and information on compliance with the legal framework.
Accident Insurance Institute (AUVA). The AUVA is the largest public accident insurance in Austria. It offers companies and employees guidance and training on the creation of safer workplaces. It also provides treatment and medical and vocational rehabilitation for workers who have suffered an accident at work, in addition to financial compensation for these workers.
Healthy Austria Fund (FGÖ). The Fund is the official body providing funding for health promotion measures, including occupational health promotion, in Austria. It also conducts training to transmit competences in health promotion. In some provinces, additional funds exist.
Pension Insurance Institute (PV). The PV is responsible for the payout of disability benefits, which includes work capacity assessments for applicants. It also provides medical rehabilitation through its own centres and vocational rehabilitation jointly with the PES.
Public Employment Service. The Austrian Public Employment Service is mainly responsible for the labour market reintegration of unemployed jobseekers with health issues. It offers vocational rehabilitation measures and charges the PV with work capability assessments if doubt arise about the capacity to work of an individual registered with the PES. PES and PV jointly conduct vocational rehabilitation.
Social Ministry Service (SMS). The SMS support people with disabilities or health issues. This mainly takes place through the “Network Job Assistance” which offers a range of services.
Austrian Health Insurance (ÖGK). The ÖGK is the main public provider of health insurance in Austria. It offers guidance and assistance for companies who want to implement health promotion measures in the workplace, and also certifies companies for a quality label on occupational health promotion. Its responsibilities in the field of return to work have also increased in recent years. In particular, it is one of the institutions managing the disability benefit system and responsible for medical rehabilitation measures.
In recent years, there have been increasing efforts to improve co‑ordination across the various policy fields and actors in (occupational) health policy.4 Most recently, in 2019, the national strategy on health at work (Gesundheit im Betrieb) was introduced, seeking to develop a co‑ordinated and comprehensive approach to managing health at work (BMAFJ, 2020[23]). Governance of the strategy includes all actors involved in occupational health policy, including various national ministries, the social, health, occupational accident and pension insurance, the provinces and the social partners.
The national strategy on health at work addresses both prevention measures in the workplace and return to work. Concretely, it is built around three pillars of occupational health management (Betriebliches Gesundheitsmanagement): binding regulation on occupational safety and health, occupational health promotion, and return to work. The national strategy does not aim to introduce new policy measures in these three areas. Rather, it seeks to establish a common understanding of occupational health management across actors, improve co‑ordination, further develop and expand existing structures where necessary and make information more accessible for companies. To achieve this, a range of actions are being implemented, such as establishing a monitoring system, the (further) development of resources for companies, improved communication and information measures and quality assurance (Box 2.9). Outputs of the strategy to date include, for instance, the adoption of a joint definition of occupational health management and the publication of a first monitoring report including recommendations on data collection and policy development (Langmann, Kvas and Breil, 2023[21]). A website on health at work, which includes resources for companies and an online assessment tool, has also been created.
The national strategy consists of three consecutive phases:
Phase A focuses on foundational elements. This includes developing a monitoring system to measure outputs, outcomes and impact of the strategy and creating an overview of all existing offers and instruments related to occupational health management. One key outcome of these efforts so far is a website summarising key information on health at work, including good practices and services available to companies (www.gesundheit-im-betrieb.at/).
Phase B centres around the development of guidance for companies. Elements of phase B include developing an online tool and guidance services for companies to check their progress with regard to occupational health management, strengthening qualification measures for counsellors, and introducing standardised communication materials, a networking platform and further publicity measures. For instance, the website on health at work includes a tool where companies can assess their progress in health at work and receive guidance and recommendations (BGM-Check).
Phase C focuses on providers in the occupational health management space and quality assurance. It envisions further developing existing quality assurance measures and evaluation tools.
Source: BMAFJ (2020[23]), Nationale Strategie “Gesundheit im Betrieb”[ National strategy ‘Health in the workplace’].
2.3.2. Increasing the presence of preventative measures in the workplace
Investment in health prevention measures in the workplace is paramount for enabling longer working lives at high levels of health and well-being. Many legal provisions on occupational health and safety – which constitute the first pillar of the Austrian national strategy for health at work – exist in Austria. The Act on Employee Protection (ArbeitnehmerInnenschutzgesetz), adopted in 1994,5 and related laws specify a number of legal obligations related to the health and safety of employees (Eppel, Leoni and Mahringer, 2016[20]). Examples of areas addressed by legislation include, among others, safety of workplaces, noise protection, design of offices, provisions relating to dangerous substances, and task content (Rosian-Schilkuta et al., 2016[24]). The legislation requires companies to undertake and document a regular workplace risk assessment and to make use of preventive expert (internal or external) services (Ibid.). In 2013, an amendment to the Act on Employee Protection reinforced the requirement that assessments have to take into account not only physical but also psycho-social risks (Eppel, Leoni and Mahringer, 2016[20]).
According to various stakeholders, the 2013 amendment led to a stronger anchoring of health as a subject of importance within companies (Schnabel and Gollner, 2017[25]).Nevertheless, in a survey carried out between November 2016 and March 2017, only 41% of companies indicated that they had undertaken an assessment of psycho-social risks (Schnabel and Gollner, 2017[25]). More recent data on implementation of the new provision is not available. However, data from the 2019 ESENER survey shows that Austrian companies - in line with the rest of the EU - are much less likely to make use of psychologists than other health and safety services, and that the proportion of establishments using psychologists has actually slightly declined since 2014 (Figure 2.3).
Share of companies in Austria and the EU using different types of health and safety services, 2014 and 2019
Note: Data refers to both in-house and externally contracted services.
Source: OECD calculations based on EU-OSHA (2022), Third European Survey of Enterprises on New and Emerging Risks (ESENER 2019): Overview Report, https://doi.org/10.2802/413156; and EU-OSHA (2016[26]), Second European Survey of Enterprises on New and Emerging Risks (ESENER‑2). Overview Report: Managing Safety and Health at Work, https://osha.europa.eu/en/publications/second-european-survey-enterprises-new-and-emerging-risks-esener-2-overview-report.
Data from international surveys can also be used to examine exposure to health risks in the workplace (Figure 2.4). Both the EU Labour Force Survey (EU LFS, Panel A) and the European Working Conditions Survey (EWCS, Panel B) examine the presence of psychosocial and physical risk factors in Austria. While the data are not directly comparable, given differences in question wording and time of data collection, it is nevertheless striking that data differ substantially with regard to the extent of exposure to various types of risk in the workplace, with the EWCS systematically pointing to much larger exposure than the LFS. This calls the validity of the data into question to an extent. However, some common messages emerge across the two datasets. First, for the majority of risk factors, improvements in exposure over time can be observed. Second, psychosocial risks such as time pressure and working at high speed and to tight deadlines, emerge as risks that a large proportion of the workforce is exposed to, though there are some improvements over time.
Note: Data for tiring or painful positions, repetitive arm movements and dealing with difficult customers/patients etc not available for 2013 (Panel A).
Source: OECD calculations based on Eurostat datasets: Persons reporting exposure to risk factors that can adversely affect physical health by sex, age and factor, Persons reporting exposure to risk factors that can adversely affect mental well-being by sex, age and factor (Panel A) and Eurofound (2023), European Working Conditions Survey (Panel B) (accessed on 20 September 2024).
The general picture of improvements in exposure to risk factors over time is also confirmed by data from the Austrian Work Climate Index, a yearly survey of satisfaction at work among Austrian employees. In a long-term perspective, the presence of both physical and mental stress factors in the workplace has decreased substantially. From the onset of the COVID‑19 pandemic, a significant increase in both physical and mental stress was recorded. However, the most recent data points to renewed decreases in stress in the workplace.
Value of the mental and physical stress indices, Austria, February 1997‑ February 2023
Note: The mental stress indicator is calculated by aggregating survey questions asking about time pressure and mentally taxing work. The physical stress indicator is calculated by aggregating questions about bad health conditions and risk of accidents or injuries at work.
Source: OECD calculations based on data from Arbeiterkammer Oberösterreich (2024): Arbeitsklima Index Datenbank. Available at: AK OÖ Arbeitsklima Index (Accessed 13 November 2024).
In addition to legal provisions on health and safety, companies can also introduce measures that promote employee health and well-being on a voluntary basis. In Austria, the diffusion of such measures started in the 1990s and has increased significantly since then, albeit largely without common quality standards (Eppel, Leoni and Mahringer, 2016[20]). With the introduction of the Health Promotion Act in 1998, the possibility of public funding for health promotion was first anchored in Austrian law, with a yearly budget of EUR 7.25 million (Lückenbach et al., 2023[27]). A large part of this funding aims at occupational health promotion measures. Some health promotion consultation is offered for free or at low cost by the public health insurance and the Austrian Network for Corporate Health Promotion, but consulting is also available through private companies (Rosian-Schilkuta et al., 2016[24]). Quality standards apply, however, if the company seeks public funding for the implementation of health promotion measures or is seeking out the Austrian quality label for health promotion (Ibid.).
Data from the ESENER survey give some indication of the prevalence of health promotion measures and measures to prevent psycho-social risks in Austrian companies (Table 2.4). Health promotion measures are only present in a minority of Austrian companies, in line with the picture across the European Union. In contrast, measures to prevent psycho-social risks are, on the whole, more common, and Austria performs well in this regard in international comparison. Nevertheless, less than half of companies in Austria have introduced psycho-social risk prevention measures, for the majority of measures.
Share of companies taking various health promotion and psycho-social risk prevention measures, 2019
Source: EU-OSHA (2022[28]), Third European Survey of Enterprises on New and Emerging Risks (ESENER 2019): Overview Report, https://data.europa.eu/doi/10.2802/881291.
With regard to occupational safety and health measures that could specifically help to prolong working lives, Austria largely performs relatively well (Figure 2.6). A significant majority of companies invest in measures to preserve physical health, including equipment to help with lifting or moving, ergonomic equipment and breaks for people in uncomfortable working conditions. In addition, more than half of companies offer the possibility for people with health problems to reduce their working hours.
Share of companies implementing measures in Austria and the EU, 2019
Source: OECD calculations based on EU-OSHA (2022[28]), Third European Survey of Enterprises on New and Emerging Risks (ESENER 2019): Overview Report, https://data.europa.eu/doi/10.2802/881291.
Parsing the Austrian landscape on preventative efforts relating to health in the workplace is a difficult task, and available data remains patchy. Nevertheless, some evidence points to improvements. The presence of health risk factors in the workplace has declined over time. In addition, the incidence of both work accidents and work-related health problems across the workforce has declined over time (Figure 2.7, Panel A), though work-related health problems, in particular, remain a concern among mid-career and older workers (Panel B).
Source: OECD calculations based on Eurostat datasets: Persons reporting an accident at work by sex, age and educational attainment level Persons reporting a work-related health problem by sex, age and educational attainment level (accessed on 18 November 2024).
Despite these improvements, further effort should be invested into the development of occupational health policy. In this regard, the Austrian strategy on health at work is a welcome effort to increase standardisation, monitoring and co‑ordination. However, many of the steps of the strategy are yet to be implemented, and progress should be carefully monitored. In addition, building on the monitoring results of the national strategy, the introduction of further public support measures and structures should be considered, including increased funding and new policy measures to encourage adoption of health promotion measures in companies. For instance, across OECD countries, there is a push to increase financial incentives for the adoption of health promotion measures in companies (Box 2.10). These incentives have potential to increase the adoption of health promotion measures in firms, though they need to be designed carefully.
Different types of financial incentives for health promotion measures exist. Most common are insurance‑based incentives. In a number of OECD countries, accident insurance institutions offer lower insurance premiums to companies with better occupational health and safety outcomes, based on records of accident or ill-health prevention in previous time periods (so-called “experience rating” approaches). In some cases, premiums can also be differentiated based on ongoing initiatives. For instance, in Alberta (Canada), employers who have attained a specific health and safety certification are eligible for a 15% rebate on the premium paid to the workers’ compensation board or up to CAD 3 000 for smaller employers.
Some countries, including France, Germany, Italy, the United Kingdom and the United States (in some states), have introduced tax credits to incentivise the adoption of health promotion measures in companies. For example, in Germany, there is a tax exemption of up to EUR 600 per employee per year for health and well-being expenditures. A broad range of measures thus fall under this exemption. In some cases, more targeted tax credits have been introduced. France and the United Kingdom both have exemptions specifically designed to facilitate cycling to work.
Source: Adapted from OECD (2022[29]), Promoting Health and Well-being at Work: Policy and Practices, https://doi.org/10.1787/e179b2a5-en.
Particular attention should be paid to the development of policies to address the presence of psychosocial risk factors in the workplace. Austrian companies are significantly less likely to make use of psychologists than other health and safety services, even though psychosocial risk factors are substantially present in workplaces. OECD (2015[18]) points to several avenues for supporting employers in dealing with mental health in the workplace, including the development of evidence‑based and differentiated support procedures for employers, and further strengthening the Act on Employee Protection to increase the involvement of occupational physicians and psychologists.
2.3.3. Enabling return to work after sickness absence by intervening early
Workers who experience long spells of sickness absence are at risk of skill depreciation and increasing distance from the labour market, which can impede a successful transition back into employment (OECD, 2024[13]). Temporary forms of inability to work are strongly linked to permanent labour market exit in Austria (Eppel, Leoni and Mahringer, 2016[20]). Particularly for older workers, there is a risk of paid sick leave forming a bridge into retirement, underlining the importance of early interventions which help these workers (gradually) return to work (OECD, 2024[13]). In the Austrian context, where employers are able to dismiss workers while they are on sick leave, such interventions are particularly important.
A systematic procedure for return to work after sickness absence does not exist in Austria. However, in recent years, policymakers have taken several steps towards a more integrated and holistic return‑to‑work policy. The Work-and-Health Act (Arbeits- und Gesundheitsgesetz), introduced in 2011, first introduced an information and counselling service on return to work, implemented through the fit2work service. In 2017, the reintegration part-time scheme (WIETZ) was introduced, which enables individuals on sick leave for at least six weeks to return to work while reducing their previous working time by 25‑50% (for a detailed discussion, see Chapter 4). In addition, the disability benefit system was reformed with the aim of putting greater focus on rehabilitation and return to work. The proportion of companies in Austria who had a procedure to support employees returning to work after long-term sickness absence increased substantially between 2014 and 2019, but remained significantly below the EU rate (EU-OSHA, 2022[28]).
fit2work: A first step towards early intervention in return-to-work management
Policy on rehabilitation and reintegration into the labour market after sickness absence has traditionally been underdeveloped in Austria (Eppel, Leoni and Mahringer, 2016[20]). In recognition of this gap in support structures, the Austrian Government has attempted to establish processes that facilitate labour market reintegration in recent years. The fit2work programme (www.fit2work.at/) represents the cornerstone of these efforts. fit2work was established in 2013 as a free, accessible counselling service available throughout Austria. The service is open to all working individuals in Austria and offers counselling for workers whose employment is at risk due to physical or mental health issues, as well as for those who struggle to find employment due to health issues. The counselling process involves a first consultation, the development of a customised plan and assistance with career reorientation, where needed. Anyone can access counselling services, but individuals with sickness absence of more than 40 days are automatically contacted by the public health insurance with an invitation to participate. In addition, fit2work also offers consulting services for companies in order to assist with the creation of measures for occupational health management. Where needed, links to individual-level counselling can be made in order to assist in the development of return-to-work procedures.
In 2023, 22 775 individuals participated in a first consultation with fit2work (27 214 received basic information). Participants in fit2work tend to be older, with the largest proportion of individuals aged 50‑59 (43.6%, Table 2.5). In addition, the majority of fit2work participants are unemployed, while employed individuals are underrepresented. This can be linked to the fact that a large proportion of fit2work participants are referred by the PES (34.1%). In contrast, only a relatively small share participates after they are contacted by the public health insurance (10.1%) – that is, after 40 days of sick leave – or after receiving information from their employer (6.2%) (Sozialministeriumsservice, 2024[30]). As a result, the overall fit2work population is skewed towards older unemployed people. The proportion who participates after receiving information from a GP is also low (4.1%). On the company side, 1 743 companies participated in a first consultation. Most companies join fit2work consultations after being contacted by the programme.
The fit2work programme undergoes regular evaluation by Statistics Austria. The most recent evaluation finds that relative to a control group, the employment rates of fit2work participants dip significantly in the quarter before programme participation (Statistik Austria, 2023[31]). Within 1.5 years after participation, participants’ employment rate has almost caught up with the control group, and after four years, it is marginally higher. However, the evaluation results for company consultation are less positive. The analysis finds no effect of fit2work consultation on sickness absence rates within companies but a moderately positive effect on exits into unemployment. The evaluation also shows that participating companies already perform well on a measure of current and future employability of employees, which is retained after programme participation. As a response to the evaluation, changes have been introduced in the new programming period of fit2work, starting in 2025. For company counselling, these include directly contacting companies by mail (similar to the process for individuals), a stronger focus on reintegration management and assistance with occupational health management.
Participants in fit2work first consultations by age and labour market status, 2023
Source: OECD calculations based on Sozialministeriumsservice (2024[30]), Jahresbericht 2023 fit2work [Annual report 2023 fit2work], Wien.
Attempting reintegration when individuals are already on rehabilitation benefit is too late
Workers who are unable to work due to health issues for a longer period may be eligible for disability benefit. In 2014, the Austrian disability benefit system was fundamentally reformed with the aim of encouraging return to work for individuals claiming a disability benefit who still have some capacity to work (for a detailed description see OECD (2015[18]). Under the previous system, workers who were temporarily unable to work had to apply for a temporary disability benefit. Following the reform, disability benefit was restricted to workers permanently unable to work. Those who would have received temporary disability benefit are now, instead, paid a rehabilitation or retraining benefit and are entitled to medical and vocational rehabilitation to restore their ability to work. When workers are unable to return to their previous occupation but generally able to work, retraining benefit involves some form of reskilling measure. In 2023, 8 229 new entries into rehabilitation benefit were recorded, 5 727 of which fall in the age group 45‑59. One-third of new entrants (2 271) was aged 55‑59. In comparison, take‑up of retraining benefit is negligible, with only about 100 participants per year.
The aim of the disability benefit reform was to enable more recipients to rejoin the labour market. However, an evaluation showed disappointing results. While the reform lead to a 40% increase in receipt of rehabilitation benefit, it had only a marginal effect on recipients’ employment participation, and no effect on unemployment or receipt of sickness benefit (Haller, Stuabli and Zweimüller, 2019[32]). More recent data, albeit descriptive, also confirms the apparent failure of the reform (Table 2.6). For 69% of all workers who started receiving rehabilitation benefit between 2014 and 2021, zero days in employment were recorded in the years after benefit receipt (up to September 2024). A further 7% only worked for 100 days or less. Employment of more than 300 days was only recorded for 18.8% of all benefit recipients. These outcomes are slightly worse among older benefit recipients, with zero days in employment post benefit receipt for 72.1% of workers aged 40‑40 and 73.5% of workers aged 50‑59.
Days spent in work after receipt of rehabilitation benefit for all individuals who were receiving rehabilitation benefit between 2014 and 2021
Note: Calculation includes all recipients who started receiving rehabilitation benefit between 2014 and 2022. Data on days worked includes information up to 13 September 2024. Length of employment given in the table is derived by adding all employment spells recorded in the data, which are not necessarily continuous.
Source: OECD calculations based on data extraction provided by the Austrian Health Insurance (ÖGK).
The new system requires sustained and unprecedented co‑operation between a number of different actors, as pointed out by various experts when it was introduced (OECD, 2015[18]; Eppel, Leoni and Mahringer, 2016[20]). This includes the Pension Insurance Authority, health insurance providers and the PES. Close co‑ordination between the Pension Insurance Authority and the PES is required for the determination of avenues for vocational rehabilitation, while pension and health insurance authorities have to work together on medical rehabilitation. According to various Austrian stakeholders, the interface between these different institutions remains a significant challenge, as no one institution has overall responsibility for management of the system. In addition, the disability pension reform, while shifting responsibility to various stakeholders, did not create financial incentives for these institutions to invest in co‑operation. While the health insurance is responsible for payment of rehabilitation benefit, the costs are fully reimbursed by the Pension Insurance Authority, as are payments for retraining benefit fronted by the PES (BMSGPK, 2022[33]).
More fundamentally, however, intervention comes too late for many people who receive rehabilitation or retraining benefit. Rehabilitation only occurs when individuals have already had health issues and been removed from the labour market for a long time (OECD, 2015[18]; Eppel, Leoni and Mahringer, 2016[20]). Pre‑reform evidence showed that individuals whose applications for disability benefit are rejected tend not to ever re‑enter the labour market; within a follow-up period of five years, people were employed for only half a year on average (Fuchs, 2013[34]). Current data on employment patterns after rehabilitation benefit receipt, as shown in Table 2.6, is similarly discouraging. Given that the group of rehabilitation or retraining benefit recipients is made up of individuals whose disability benefit claim is rejected, it is clear that labour market reintegration for these disadvantaged groups is extremely difficult. This further underlines the need for better and much earlier management of sickness absences in the Austrian system, to avoid a situation where individuals can no longer be reintegrated into the labour market.
Towards a stronger emphasis on early intervention and sickness absence case management in Austria
The management of return to work after sickness absence has been a point of weakness in Austrian occupational health management policy. In recent years, policymakers have introduced several measures aimed at establishing better procedures and support systems for facilitating return to work after a period of sickness absence. Yet, despite some moves towards early intervention, individuals who are at risk of dropping out of the labour market could be reached much earlier. The fit2work programme is an important step in the right direction, introducing an easily accessible service for individuals with (potential) health issues inhibiting them from working. However, it is a purely voluntary service, and the majority of participants are already unemployed when they start a fit2work consultation. Health issues need to be identified much earlier and individuals at risk contacted proactively. One example is Switzerland, which undertook significant reforms of its disability benefit system to identify workers at risk of dropping out of the labour market early on (Box 2.11).
Switzerland has undertaken a serious of significant reforms to its disability benefit scheme. The 5th revision of the Disability Insurance Act, introduced in 2008, focused on vocational rehabilitation and job retention.
One significant element of the reform was a focus on early identification of individuals who are at risk of becoming a person with disability. It introduced a low-threshold application to the disability insurance which could be used after a 30‑day sickness absence or after several short-term absences. A variety of actors can use the form, including claimants, employers, social and private insurers, doctors, relatives or social welfare officers. Claimants are then connected with a counsellor who can introduce a range of early intervention measures to secure job retention, such as workplace adaptations or educational courses, or, if needed, measures to assist in finding a new job. Data shows that claimants who access disability benefit through the early registration process are more likely to still be employed, which increases prospects for job retention or return to work.
Another feature of the reform was that within this early intervention period, a decision about the further direction of measures is executed within 180 days. The intention of the rather short decision time is that the claimant has clarity about the future direction of measures and can focus on return to work rather than being stuck in the process.
Source: Adapted from OECD (2014[35]), Mental Health and Work: Switzerland, https://doi.org/10.1787/9789264204973-en.
Moreover, to enable early intervention, actors in the health policy space need to be integrated into the process much more comprehensively. First, General Practitioners (GPs) remain disconnected from occupational health policy, as they often have no training in vocational rehabilitation (OECD, 2015[18]). GPs are de facto critical gatekeepers to the social security system, also in Austria. Several OECD countries have introduced binding guidelines for GPs on how to manage sickness absences and return to work in order to build capacity in this area and to prevent overly long absences for diseases for which a faster return to work would be desirable to prevent labour market exit (OECD, 2015[36]).
In addition, processes for sickness absence management and return to work need to be improved. A systematic monitoring and case management approach to sickness absence, which exists in several other OECD countries, has not been established in Austria until now (Eppel, Leoni and Mahringer, 2016[20]). The absence of clear responsibilities for monitoring absences and providing follow up and case management at early stages of sick leave is a barrier to effective labour market reintegration. In Austria, the health insurance authority is the holder of sickness absence data and, therefore, best placed to take a key role in this space. The authority is responsible for monitoring to some degree and people on sick leave are randomly selected for control exams by an insurance doctor, but it does not use its evidence and capacity systematically to identify sick workers who are likely to need help in the return-to-work process early on and it is not linked with any of the authorities potentially able to provide such support, like fit2work. Several OECD countries have introduced measures for a more integrated approach towards return to work involving systematic case management and clearly defined procedures for all longer-term absentees, not only those who choose to seek additional support as is the case with the voluntary Austrian fit2work programme (Box 2.12). These countries provide examples for the further development of return-to-work policy in Austria. Austria should move towards more clearly defined mandatory processes for sickness absence management with involvement of and clear roles for all stakeholders, including employers and employees but also GPs, under a dedicated responsible authority.
A number of OECD countries have implemented systematic and mandatory case management approaches to sickness absence which rely on co‑ordination across the different institutions involved. In Denmark, integrated rehabilitation services are located in municipal job centres. An interdisciplinary rehabilitation team oversees the process, which also involves the health sector, labour market institutions, social services and the education sector. The rehabilitation team discusses needs and makes recommendations for each case, with a co‑ordinator responsible for the overall process and steering clients through it. In Switzerland, in contrast, case management is usually done by private health insurers. Sickness-related case management tends to start early, with the case manager assessing whether a sickness absence should be reported, in which case they contact the treating physician, the employer and the employee. On the basis of information gathered from different sources, they establish a co‑ordinated return-to-work plan. In the Netherlands – where employers pay salaries for up to two years of sickness absence and workers are protected against layoff – responsibility for case management falls on employers, who are obliged to hire or engage a case manager to oversee the return-to-work process.
In Sweden, interinstitutional co‑ordination is incentivised through integrated finances. DELTA, a local association, ensures financial co‑ordination between the national employment service, the regional health authority, the municipal social service and the national social insurance department, which jointly fund DELTA. The association was established in 1997 to improve cross-sector and cross-institutional co‑ordination in the field of rehabilitation. The joint budget is allocated to the different rehabilitation services provided by DELTA, which include social and medical activities to shorten patient treatment, occupational activities to speed up return to work and preventive activities to avert sickness absence and social exclusion. These activities are carried out by multidisciplinary teams and supervised by co‑ordinators appointed by DELTA. Evaluations have shown that DELTA has improved job-finding outcomes, but drawbacks are the voluntary nature of financial co‑ordination and the lack of employer involvement.
Several countries also have clearly defined procedures for sickness absence. For instance, Sweden has undertaken a series of reforms since 2003 to address structural issues in sickness and disability policies. The reform introduced a strict timeline for work-capacity assessments at different stages. Work capacity is first assessed in relation to the previous job, then, after three months, in relation to other positions with the same employer, and, after six months, in relation to the entire labour market. This was complemented by reforms to the length of sickness benefits. Numbers of sickness and disability benefit recipients decreased substantially following the reform.
In several countries, e.g. the Netherlands, Norway and Sweden, procedures for sickness absence must involve the employer, who has to agree a mandatory reintegration plan in co‑ordination with the employee. In the Netherlands, within eight weeks of sickness absence, employer and employee have to agree on an action plan, which spells out the responsibilities of both sides for a quick return to work. In Norway, employer involvement in return to work is regulated in a tripartite workplace agreement, covering around 60% of all employees. The agreement obliges firms to seek and facilitate dialogue with sick-listed employees. While confidentiality of the medical situation is of course also maintained in these countries, employers and employees must talk about work and workplace adjustments necessary to enable a faster return to work.
Source: Adapted from OECD (2015[36]), Fit Mind, Fit Job: From Evidence to Practice in Mental Health and Work, https://doi.org/10.1787/9789264228283-en.
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← 1. The other six are retaining and attracting personnel, vocational continuing education and training, retaining employment through capacity fluctuations, creating equal opportunities for women, diversity in the company-integration of labour market target groups, and green transition.
← 4. For instance, in 2012, ten framework health goals were developed as part of the push towards “health in all policies”, one of the goals being “living and working conditions that promote health for all population groups through co‑operation of all policy and societal areas”. In 2014, the Health Promotion Strategy was designed to develop a framework for health promotion in Austria based on these goals (Rosian-Schilkuta et al., 2016[24]).
← 5. The Employee Protection Act reaffirms and build on a range of previous legal provisions on employee protection in Austria. It was adopted to align provisions in Austria with EU law falling the adoption of EU Directive 89/391/EEC on “the introduction of measures to encourage improvements in the safety and health of workers at work”.