„The German hospital market“ GTAI webinar Berlin, 05 March 2015 RA Marc Schreiner, LL.M. Director EU-policies, international affairs, health economics German Hospital Federation (DKG – Deutsche Krankenhausgesellschaft e.V.) RA Marc Schreiner, LL.M.
German Hospital Federation • Representative organ of all German hospitals, no mandatory membership • 28 member organisations (16 hospital federations on state level, 12 association on the federal level on each special type of ownership, e.g. catholic and evangelic churches, universities, municipalities and counties, private for profit companies, pension funds, etc.) • Partner of politicians on national, European and international level • Key player in the self-government-system of the German health care sector (e.g. in the Federal Joint Committee) • Development of the German DRG-System RA Marc Schreiner, LL.M.
Hospitals owners I shares of hospitals (in %) shares of hospital owners 2013 compared to 2012 private; charity 694; based; 34,8% 706; 35,4% 2013 public; 596; 29,9% 2,0% 0,0% -0,4% -0,8% -2,0% -1,8% -4,0% public charity based private March 2015 Source: Federal Statistics Agency March 2015 RA Marc Schreiner, LL.M.
Hospitals owners II development – share of hospital owners (share in %, share N) 100% 369 381 401 409 407 420 453 468 486 512 527 545 555 570 584 620 637 667 679 678 697 694 private hospitals 34,8% 80% 950 950 949 944 929 919 60% 920 930 912 903 877 856 831 818 803 790 781 769 charity based 755 746 719 706 35,4% hospitals 40% 1062 1023 987 972 20% 933 919 890 854 844 825 817 796 780 751 717 677 665 648 public hospitals 630 29,9% 621 601 596 0% 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 20122013 March 2015 Source: Federal Statistics Agency RA Marc Schreiner, LL.M.
Key data I hospitals, beds, degree of utilisation 110 Index (Year 2000 = 100) 100 (3) (2) 90 (1) 80 2000 2002 2004 2006 2008 2010 2012 2013 hospitals (1) beds (2) occupancy rate (3) March 2015 Source: Federal Statistics Agency RA Marc Schreiner, LL.M.
Key data II occupancy days, number of inpatient care, length of stay 110 (2) 100 Index (Year 2000 = 100) 90 (1) 80 (3) 70 2000 2002 2004 2006 2008 2010 2012 2013 occupancy days (1) cases (2) length of stay (3) March 2015 Source: Federal Statistics Agency RA Marc Schreiner, LL.M.
Key data III summary: development course key data of German hospitals (2) beds (1) 120 number of cases (2) occupancy rate (3) Index (Year 1991 = 100) lenght of stay [days] (4) 100 occupancy days (5) (3) hospitals (6) (6) 80 (1) (5) 60 (4) 40 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 2013 Source: Federal Statistics Agency March 2015 RA Marc Schreiner, LL.M.
SHI-Expenses SHI – statutory health insurance allocation (2013) and development of SHI-expenses others 24,3% pharma 16,5% 2013 hospitals dentists 35,1% 6,9% 160 physicians (4) 16,4% Index (year 2000 = 100) (2) 140 (1) 120 (3) 100 80 2000 2002 2004 2006 2008 2010 2012 2013 inpatient treatment (1) physicians (2) dentists (3) pharmaceutical (4) March 2015 Source: BMG RA Marc Schreiner, LL.M.
PHI-Expenses PHI – private health insurance allocation and development of PHI - expenses others 27% hospitals 26% pharma 10% 2013 dentists (3) physicians 15% 22% (4) Index (year 2000 = 100) (2) 180 (1) 140 100 60 2000 2002 2004 2006 2008 2010 20122013 inpatient treatment (1) physicians (2) dentists (3) pharmaceutical (4) March 2015 RA Marc Schreiner, LL.M.
Subsidies granted by states 2012/2013 development of the subsidies (1991 = 100) 130 120 West East 110 100 90 80 70 60 50 40 1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 subsidies per bed - 2013 10.000 8.000 6.000 Euro 4.000 2.000 0 BW BY BE BB HB HH HE MV Ni NRW RP SL SN ST SH TH March 2015 Source: survey conducted by the hospital working group of the states‘ health authorities RA Marc Schreiner, LL.M.
Hospital staff development the hospital staffing in full-time equivalents (fte) (1) 130 Index (year 2000 = 100) 120 110 (3) 100 (2) 90 80 2000 2002 2004 2006 2008 2010 20122013 Ärzte (1) nichtärztliches Personal (2) Beschäftigte insgesamt (3) doctors (1) others (2) employees altogether (3) March 2015 Source: Federal Statistics Agency *excl. non-full-time doctors/dentists and excl. personnel in training RA Marc Schreiner, LL.M. institutions
Structure of medical professions 2013 (numbers in thousand) total number of physicians 470,4 without medical active physicians 357,2 activity 113,2 primary care authorities/public others inpatient care 145,9 bodies 9,6 20,7 181,0 salaried private executive non conductive physicians 22,3 physicians 123,6 physicians 166,1 physicians 14,9 March 2015 Source: Federal Chambers of Doctors RA Marc Schreiner, LL.M.
Facts at a glance beds : ca. 500.000 public: ca. 220.000 private: ca. 80.000 charity based: ca. 160.000 hospitals : almost 2.000 income : ca. 86 billion € public: 596 SHI: 64,2 billion. € private: 694 PHI: 6,9 billion. € charity based: 706 investment: 2,7 billion. € 18,8 Mio. inpatient patients 20 Mio. ambulatory patients employees : 1,1 Mio. 180.000 doctors 400.000 nurses occupancy rate : 77,3 % occupancy days: 142 Mio. length of stay : 7,5 days RA Marc Schreiner, LL.M. (Eur. Integration)
Hospitals On the same legal basis Reimbursement under the same conditions Same working conditions Open to all patients/ Free choice Same quality standards Same admission conditions RA Marc Schreiner, LL.M.
Thanks and contacts German Hospital Federation RA Marc Schreiner, LL.M. Director EU-Policies/International Affairs Health economics Wegelystraße 3 10623 Berlin Phone: +49 (0)30 – 39801 1030 Fax: +49 (0)30 – 39801 3011 Mail: m.schreiner@dkgev.de Internet: www.dkgev.de RA Marc Schreiner, LL.M.
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