Abstract
BACKGROUND: Health reform sees health promotion (HP) and health literacy (HL) as essential cornerstones for achieving health policy goals. This article examines the extent to which the legal foundation in the Austrian healthcare system provides a basis for orientation towards HP and HL. The focus of the analysis was set on medical professions, the health care and nursing professions, hospitals, and primary health care facilities. METHODS: In a first step, legal and other relevant documents were reviewed. For this, a literature-based coding grid was created. In a second step, the legal bases were analyzed and interpreted using the coding grid. Recommendations were derived from the analysis of the legal basis and experts' assessments. RESULTS: Health promotion and health literacy are included in the general legal foundations. However, HP/HL is primarily conceived as a supplementary service with separate financing and is thus less understood as an integral part of any patient contact. The primary health care units and the nursing professions have a relatively clear mandate with regard to HP/HL compared to the hospitals and medical professions. Overall, it was recognized that terminology should be used more coherently and operationalized for the respective areas of cure and care. In particular, the legal bases relating to the medical professions do not build on one another in a coherent manner. CONCLUSIONS: Having adequate staff is the key to HP/HL. If these are in place, competencies in the field of HP/HL should be required, promoted, evaluated, and rewarded. HP/HL should be an integral part of any care setting. The concepts of health promotion and health literacy should be operationalized in the legal frameworks of health professions and organizations. This is especially true for the Physicians' Act and for hospitals. Furthermore, the role of patients should be strengthened and the involvement of users in the planning of health services should be further developed.