Berlin - After two comparatively good years for German hospitals, their situation deteriorated again in 2011. That was the opinion of the authors of the “Hospital Rating Report 2013”, which was presented today at the capital city congress in Berlin. Three quarters of 887 hospitals examined therefore had low risk of becoming insolvent within year in 2011. In the two previous years it was more than four fifths. In 2011, 11.3 percent of the hospitals surveyed had significant problems obtaining loans and thus an increased risk of becoming insolvent the following year. In 2010 this value was 7.1 percent.
"After noticeable improvement in the economic situation between 2008 and 2010, the situation was again as difficult as in 2008," the report says. The reason for this was, among other things, the new hires in the personnel area - with an increase of 1.7 percent, the highest in the past ten years, said Sebastian Krolop from the consulting service provider Accenture, one of the authors of the study. In the medical field, the number of full-time employees increased by 3.6 percent in 2011, in the nursing field by two percent and in the medical-technical service by 4.1 percent. In the non-medical area, however, the number of employees fell by 3.5 percent.
Investment ability worsened According to the report, the investment capacity of hospitals deteriorated in 2011. While 57 percent of the houses were still fully investable in the previous year, their number fell to 40 percent in 2011. The number of hospitals that were unable to invest on their own rose from 34 to 43 percent.
According to Krolop, the hospitals in East Germany were much better off than the hospitals in the West. There are massive problems in the south and north in particular. For example, 47 percent of the hospitals in Baden-Württemberg reported an annual loss in 2011, 41 percent in Rhineland-Palatinate and Saarland and 40 percent in North Rhine-Westphalia. In Berlin, Brandenburg and Mecklenburg-Western Pomerania, on the other hand, only 17 percent generated an annual loss.
There are fewer carrier-specific differences in the east In contrast to the private sector, it is the public and non-profit sectors Hospitals failed to improve their economic situation between 2008 and 2011, the report said. The big difference between the sponsorships is, however, West German phenomenon. In East Germany, only minor differences between the providers are noticeable. In 2011, according to the report, 40 percent of municipal hospitals achieved an annual surplus of at least one percent. For the non-profit it was 45 percent and for the private 87 percent.
Overall, the period from 2005 to 2011 was characterized by strong volume dynamics, write the authors of the report. The number of inpatient cases increased by eleven percent, the DRG revenues by 29 percent. The more specialized house is, the more successful it is economically, explained Krolop.
According to the report, hospital capacities have changed little in 2011 compared to the previous year. The number of beds remained almost unchanged at 502,000; the number of hospitals decreased by one percent to 2,045. Private hospitals were able to increase their market share slightly from 15.9 to 16.3 percent. The market share of public-law houses fell from 49.7 to 49.3 percent, the share of non-profit houses stagnated at 34.4 percent.
The number of hospital operators, however, continued to fall, in 2011 it was 1,121 - In 1995 it was 1,598. The number of individual hospitals that are not part of chain also fell further, from 54.7 percent in 1995 to 38.5 percent in 2011. In the past two years, the number of provider changes has decreased, according to Krolop. "But we assume that this will pick up speed again in the future."
Study authors for reducing hospitals The authors of the rating report are in favor of reducing hospitals in Germany from: “The supply density in Germany, which is generous in international comparison, offers ideal conditions for bundling the scarce resources to fewer, but larger service providers. This would be more efficient than distributing it to many small ones, especially in the federal states with particularly difficult economic situation for their hospitals. ”
The managing director of, Matthias Blum, criticized the thesis that the hospitals' dramatic economic situation was one An expression of an oversupply of hospitals and the market shakeout is solution strategy. “How high should the work density still be?” Asked Blum. In addition, the hospitals are “jam-packed” at peak times, for example during flu wave, and every bed is needed. And every hospital that is in the hospital plan is also "required" according to the legal situation. How should one make selection?
"I read in the Hospital Rating Report that the economy comes first," criticized Blum. But one cannot subordinate everything else to the economy. Because it's more than about money.
"I am concerned that the question of where the investment funds for the hospitals should come from has been pushed back and forth between the federal and state levels for 35 years," said Joachim, the chairman of the managing directors of the municipal hospital operator Bovelet. Politicians must be obliged to meet their funding obligations.In addition, he had the feeling that the pressure to perform among staff had reached limit that should not be exceeded.
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