The latest „Hospital Rating Report“ from 2018 and 2019, with data from annual financial statements of a total of 951 hospitals, shows that 13 percent of hospitals and clinics were at risk of insolvency in 2019, compared with only four percent in 2016. In 2017 and 2018, it was eleven percent in each case. Accordingly, a negative annual result could now be seen at exactly one-third of all hospitals in 2019; in the previous three years, it was only 17.6 percent that had a negative annual result. Declining figures were also observed in the „green sector,“ according to the study authors led by Boris Augurzky and Adam Pilny of the Leibniz Institute for Economic Research (RWI), who were involved in the study.
In 2020, there was a further slump resulting from falling inpatient case numbers of 13 percent, which were as high as 30 percent at the beginning of the year. A poor forecast has also already been confirmed for 2021.
According to the analysis by RWI in collaboration with the Institute for Healthcare Business GmbH, the Bank im Bistum Essen, and the Healthcare Information and Management System Society, or HIMSS, large hospitals are better off than small provincial hospitals. The large hospitals that operate most efficiently have 600 to 900 beds and revenues of between 140 and 190 million euros, are usually specialized clinics, belong to a chain, and are non-profit or private. Public hospitals are not as effective.
The study authors criticize the too low investment costs of the federal states as the main reason for poor utilization and thus for the poor economic situation of the hospitals. Whereas in 1990, investment costs about hospital revenues were still ten percent, in 2019, they were only 3.5 percent. The experts in the study results conclude that seven to eight percent would be ideal.
Boris Augurzky, one of the study’s teams of authors, cautions that the main reason for the unfortunate situation is the exclusion of nursing personnel costs from diagnosis-related per-case flat rates. In addition, competition for nursing staff continues to increase each year, as many nurses reorient themselves and look for other jobs. One in six nurses is included in the high turnover rate in nursing. Medical professionals are also increasingly working part-time, as the „Hospital Rating Report“ points out. According to the report, 38 percent of contract physicians worked part-time in 2019, while the situation was much more relaxed in 2009, at just eight percent.
In addition, 24 percent of outpatient physicians will be working as employees in 2020; in 2008, only a quarter of them was not self-employed.
Source: Aerzteblatt.de