Closing every second hospital would improve healthcare in Germany: study

More than half of all hospitals in Germany should be closed in order to improve patient care, according to a study published by the Bertelsmann Foundation on Monday.

“The reorganization of the hospital landscape is a question of patient safety and must above all pursue the goal of improving the quality of care,” said Brigitte Mohn, member of the board at Bertelsmann.

According to the Bertelsmann study, “many complications and deaths could be avoided by concentrating on well under 600 clinics instead of just under 1,400 today.”

Reducing the number of hospitals in Germany would lead to better equipment, greater specialization and better care by specialists and nursing staff in the remaining hospitals, the report stated.

“Only clinics with larger specialist departments and more patients have sufficient experience for safe treatment,” emphasized the authors.

Furthermore, only in sufficiently large hospitals could specialist positions be filled around the clock and other important equipment is available in Germany, the study noted.

“There are too few medical staff to maintain the number of clinics,” said Bertelsmann project manager Jan Boecken.

In an international comparison, Germany had on average more medical personnel per inhabitant than comparable countries, but less per patient.

In Sweden and the Netherlands, for example, more than twice as many nurses cared for inpatients in hospitals than in Germany, health expert Anke Simon told the broadcaster ZDF.

The Bertelsmann study authors pointed out that the number of so-called bed days per inhabitant in Germany was 70 percent higher than the average for comparable European Union (EU) countries.

Currently, one-third of German hospitals had fewer than 100 beds while the average size of clinics was less than 300 beds, according to the study.

At the same time, many more patients in Germany were treated in hospitals than in other countries. The Bertelsmann experts argued that every year, around 5 million patients could be operated on or treated on an outpatient basis in Germany.

“In many clinics, the quantities are far too small to gain the experience needed to carry out these treatments and to have the personnel and equipment needed to provide adequate treatment,” Thomas Mansky from the Technical University Berlin told the German news program Tagesschau.

“We have taken note of this study and will take a closer look at it,” said a spokesperson from the German Ministry of Health on Monday.

Hospital planning was the responsibility of each individual German federal state and they had to ensure a “needs-based care of the population” was provided, according to the German health ministry spokesperson.

Although the health ministry spokesperson acknowledged that Germany had an above-average number of hospital beds and clinics compared to other countries, it was not only “about the sheer number of hospitals,” but “above all about accessible and high-quality care.”

German Minister for Health Jens Spahn has recently emphasized the need for quickly accessible local care, especially for health emergencies.

“A local hospital is a piece of home for many citizens. It gives them comfort and security,” Spahn stressed recently.

He promised to provide hospitals in rural regions of Germany with flat-rate subsidy of 400,000 euros (450,600 U.S. dollars) per year.

The Bertelsmann study published on Monday showed, however, that focusing primarily on ensuring fast access to small local hospitals in Germany was not always an advantage.

“If a stroke patient reaches the nearest clinic after 30 minutes, but does not find an appropriately qualified doctor and the medically necessary specialist department there, they would certainly have preferred to be driven a few minutes longer to a well-equipped clinic,” said Bertelsmann board member Mohn.

The economic situation at German hospitals has been deteriorating in recent years and last year, with 12 percent of hospitals at increased risk of insolvency, according to a hospital rating compiled by the Leibniz Institute for Economic Research (RWI).

If nothing changed in the next few years, about 18 percent of German clinics would be at high risk of insolvency by 2025, predicted the RWI researchers.