In order to improve the quality of patient care, a new study has recommended that the number of hospitals in Germany should be radically reduced. 

Large hospitals in Germany offer better care

The report, which was commissioned by the Bertelsmann Foundation earlier this year and published yesterday, recommends that the number of hospitals in Germany be reduced from the current 1.400 to less than 600. This would allow the remaining hospitals to have more staff and better facilities. 

The study’s researchers, from the Berlin Institute for Health and Social Research, found that smaller clinics in Germany often lack the necessary equipment and experience to appropriately deal with life-threatening emergencies such as heart attacks and strokes. “Only clinics with larger departments and more patients have enough experience for safe treatment,” they write, pointing out that complications and deaths could be avoided by pooling doctors and nurses in fewer hospitals. 

Not only would this allow staff access to better-quality medical equipment, but it would also enable hospitals to overcome staffing shortages. “There are too few medical staff to maintain the number of hospitals,” writes the Bertelsmann project manager, Jan Böcken. 

Patients want local hospitals

A reduction in the number of hospitals in Germany has long been up for discussion. Calls to cut superfluous clinics are usually countered by calls to keep rural areas within easy access of hospitals. Indeed, Federal Health Minister Jens Spahn recently stressed that “a local hospital is a piece of home for many citizens,” who want to have easily-accessible care in the case of medical emergencies.

However, the financial situation of many of Germany’s smaller hospitals is precarious. According to the latest figures from the German Hospital Association, every third clinic in 2017 was in the red. Because of this, German health insurance funds have pledged to increase funding for small and rural hospitals. Next year, 120 hospitals in Germany will receive cash injections of 400.000 euros each, totalling some 48 million euros. 

Study proposes new hospital structure in Germany

The Bertelsmann study, in contrast, states that being within easy reach of a hospital is only a perceived advantage, as patients often receive substandard treatment. If there is no specialist doctor available there, for example, the clinic is seriously disadvantaged when it comes to the quality of care. 

Instead of increasing investment in rural hospitals, therefore, the authors of the Bertelsmann study propose a new two-tier hospital structure in the German healthcare system. In addition to standard communal hospitals with around 600 beds, there should be around 50 university teaching hospitals and so-called “maximum care providers” with an average of 1.300 beds - thus allowing for the pooling of staff, facilities, experience and resources.