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The German hospital market

The total volume for hospital treatment in Germany was about €84 billion1 in 2012. Personnel costs account for about 61% of hospital costs, and material costs for 38%. Personnel and material costs rose by approximately 5% and 3%, respectively.

The number of hospitals in 2012 was 2,017 (2011: 2,045). The number of beds fell to 501,475 (2011: 502,029). Nonetheless, with 6.24 beds per 1,000 population, Germany is still well above the OECD average of 4.8 (2011). The average stay of a patient in an acute care hospital in Germany fell slightly over the same period and was 7.6 days in 2012 (2011: 7.7 days). On the other hand, the number of inpatient admissions has increased. This is largely due to changing demographics. In 2012, the number of admissions increased by about 276,000 to about 18.6 million. This is equivalent to 232 admissions per 1,000 population (2011: 229). In the years 2008 to 2012, the number of admissions in Germany rose at an average annual rate of 1.5%. The average costs per admission have increased by 3.0% on average over the five years leading up to 2012.

According to a survey by the German Hospital Institute (DKI), the economic situation at many hospitals in Germany worsened during 2012: 43% of the hospitals earned a surplus (2011: 55%), 7% achieved breakeven (2011: 14%), and 51% made a loss (2011: 31%).

Many hospitals are facing a difficult economic and financial situation as well as significant investment needs. This is due in large part to an investment backlog that has accumulated because, in the past, the federal states failed to meet their statutory obligation to finance necessary investments and major maintenance measures sufficiently due to budget constraints. Moreover, investment needs are mainly driven by technological advances, higher quality requirements, and necessary modernizations. Rheinisch-Westfälisches Institut für Wirtschaftsforschung (RWI) estimates that the investment gap at German hospitals is about €34 billion.

According to the German Federal Statistical Office, the privatization trend in the German hospital market continued in 2012, with the share of private hospital beds rising to 18.0% (2011: 17.3%). However, as the chart shows, with a share of 47.9%, the bulk of the hospital beds continued to be in the public sector (2011: 48.4%).

According to our research, about €318 million in hospital transaction revenues were acquired in 2013.

Source: German Federal Statistical Office


Quality is increasingly becoming a key competitive factor for the hospital market. Transparency and comparability of the treatments for the patients and their doctors will play an ever-more decisive role. For more information please see here.

In 2012, the post-acute care market in Germany comprised a total of 1,212 clinics, below the previous year’s 1,233. The number of beds also declined, to 168,968 (2011: 170,544).

Private clinics accounted for 65.8% of the total number of post-acute care beds (2011: 66.4%). Independent non-profit clinics and public clinics accounted for 16.1% (2011: 15.7%) and 18.1% (2011: 18.0%), respectively. The total number of admissions in Germany increased by about 39,000 admissions to 1.96 million. The average length of stay remained almost unchanged at 25.5 days.

KEY FIGURES FOR INPATIENT CARE IN GERMANY


20122011201020092008Change 2012 / 2011
Hospitals2,0172,0452,0642,0842,083-1.4%
Beds501,475502,029502,749503,341503,360-0.1%
Beds per 1,000 population6.246.266.156.156.13-0.3%
Length of stay (days)7.67.77.98.08.1-1.3%
Number of admissions (millions)18.6218.3418.0317.8217.521.5%
Average costs per admission in €14,6634,5474,4324,3274,1462.6%

20122011201020092008Change 2012 / 2011
Hospitals2,0172,0452,0642,0842,083-1.4%
Beds501,475502,029502,749503,341503,360-0.1%
Beds per 1,000 population6.246.266.156.156.13-0.3%
Length of stay (days)7.67.77.98.08.1-1.3%
Number of admissions (millions)18.6218.3418.0317.8217.521.5%
Average costs per admission in €14,6634,5474,4324,3274,1462.6%

Fresenius Helios is the largest hospital operator in Germany. Our main competitors are other private hospital operators like Rhön-Klinikum AG, Asklepios, and Sana Kliniken.

1Total costs, gross of the German hospitals less academic research and teaching

Sources: German Federal Statistical Office; German Hospital Institute (DKI), Krankenhaus Barometer 2013; OECD Health Data 2013; Rheinisch-Westfälisches Institut für Wirtschaftsforschung (RWI), Krankenhaus Rating Report 2013


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