Several analyses by the German Hospital Institute (DKI) have led to the conclusion that 75 percent of all hospitals in Germany have an insufficient investment capacity because the individual federal states cannot guarantee adequate financing of investment costs. According to this, half of all investment expenditure is now covered solely by public funds, with the other half being contributed by the hospitals themselves. However, many investments cannot be financed from own resources, such as surpluses from service fees, according to the study situation of the DKI. Insufficient investment financing has been leading to losses for hospitals for about ten years, with between 30 and 50 percent of these hospitals reporting losses. Other hospitals are making profits, but when they do make a profit it is so small that the sum is not enough to cover the investment needs or to finance loans, according to the conclusion of the DKI analysts. The dilemma ultimately leads to considerable investment backlog, especially in the area of digitalisation. Many houses are badly positioned there. Only less than half of the hospitals have standardized e-patient records and e-medication support systems. Many are also undersupplied in telemedical and telematic areas because teleconsultation and telemonitoring are not yet very widespread, but electronic decision-making in diagnostics and therapy, which would need IT support, is also lagging behind. There is also a lack of funds here, as only 2.7 million euros of public funding has passed through the German states as investment costs, although two and a half times as much would be needed, i.e. about seven billion euros per year over five years.
