GERMANY A1 Population 81.874.768 81.757.472 81.779.208 A2 Area (square Km) 357.120 357.127 357.127 A3 Average population density per square Km 229,26 228,93 228,99 A DEMOGRAPHIC AND SOCIO-ECONOMIC INDICATORS A4 Birth rate per 1000 population 8,12 8,29... A5 Death rate per 1000 population 10,44 10,50 10,42 A6 Life expectancy at birth (years) 80,30 80,50 80,80 A6a Men 77,80 78,00 78,40 A6b Women 82,80 83,00 83,20 Source: OECD Health Data, October 2013 A7 Real Gross Domestic Product (GDP) PPP$ per capita 35.630,80 37.651,60 39.456,40 Page 1 of 7
The statutory healthcare system covers 88% of the population. The rest of the population is covered either by employers (public civil servants) or B1 Healthcare coverage of population by private healthcare insurance companies (population with very high income, i.e. nearly 9% of the population). 0,3% of the population has no healthcare coverage at all. B2 Gate-keeping system General practitioners strictly control the access to hospital care. B3 Total health expenditure, PPP$ per capita 4.187 4.349 4.495 B4 Public sector health expenditure as % of total health expenditure 76,80% 76,70% 76,50% B HEALTHCARE SYSTEM B5 Product (GDP) 11,80% 11,50% 11,30% B5a Public sector health expenditure as % of GDP 9,02% 8,84% 8,40% B5b Private sector health expenditure as % of GDP 2,72% 2,68% 2,68% B6 Expenditure on inpatient care per capita (PPP$) 1.428,60 1.492,10 1.562,10 B7 Public inpatient expenditure as % of total inpatient expenditure 83,80% 84,10% 83,90% B8 Total inpatient expenditure as % of total health expenditure 34,10% 34,30% 34,80% B9 Public funding Funding through statutory social insurance but also 8% by taxes. Page 2 of 7
The public hospitals belong to the Länder, to local authorities associations or to C1 Administration and management local authorities. Hospital management may be provided in public or private structures. Hospitals may be limited companies. C HOSPITAL GOVERNANCE The federal government determines the general framework and principles for the operation and management of hospitals (principles of remuneration under C2 Surveillance authority the DRG-system, quality of insurances). The Länder are responsible for hospital planning, hospital funding and investments, the technical hospital equipment and the research and vocational training of hospital staff. Page 3 of 7
The operation expenses are funded by the healthcare insurances and the D1 Hospital financers patient contributions (co-payment). D HOSPITAL FINANCING Since January 2003, reform of hospital remuneration: progressive abolition of the D2 Modes of payment system of global budgets. Introduction, until 2009, of a system of remuneration of all hospital services according to the Australian system of DRG (Diagnosis Related Groups). D3 Use of DRGs Regardless of the status of hospitals, the Länder are responsible for hospital D4 Hospital investments investments based on their hospital development plans. Page 4 of 7
Coexistence of public hospitals, private non-for-profit hospitals and private forprofit hospitals. Note: the given figures include E1 Public / Private ownership In 2007, the 32,4% of all hospitals were public and the 67,6% of all hospitals were general hospitals, mental health private. hospitals and prevention homes. Rehabilitation homes are excluded. E1a % of hospitals private for profit 56% (790) of private hospitals in 2007 See indicators E3-E9 for details. E1b % of hospitals private not for profit 44% (620) of private hospitals in 2007 There are two categories of hospitals: E2 Categories - General Hospitals, - Mental Hospitals. E3 Total number of hospitals 3.324 3.301 3.278 E4 All hospitals per 100.000 population 4,06 4,04 4,01 E TOTAL HOSPITAL CARE PROVISION E5 Total number of hospital beds 674.830 674.473 672.573 In, rehabilitation is an 274.502 273.789 273.382 own branch of the system of social security and does not Public inpatient hospital beds (number and % of belong to the hospital sector E5a all beds) 40,68% 40,59% 40,65% beeing part of the health care. Concerning the special hospitals as e.g. psychiatric hospitals they 400.328 400.684 399.191 are also NOT counted as acute care hospitals but including 38.785 Private inpatient hospital beds (number and % of (7,65%) of the total hospital beds. E5b all beds) 59,32% 59,41% 59,35% Hence, even if they are computed in the international statistical databases (WHO - E6 All hospital beds per 100.000 population 824,22 824,97 822,43 OECD) it is considered opportune here to give their number separately. E7 Number of inpatient care admissions/discharges 19.386.524 19.621.116 19.868.738 E8 Inpatient care admissions/discharges per 100 population 23,68% 24,00% 24,30% E9 Average length of stay for all hospitals (bed-days) 9,70 9,50 9,30 Page 5 of 7
F1 Number of acute care hospitals 1.780 1.758 1.736 F1a Acute care hospitals as % of all hospitals 53,55% 53,26% 52,96% F2 Acute care hospitals per 100.000 population 2,17 2,15 2,12 F3 Number of acute care hospital beds 437.863 435.954 434.087 F ACUTE CARE HOSPITAL PROVISION F3a Acute care hospital beds as % of all hospitals beds 64,88% 64,64% 64,54% F4 Acute care hospital beds per 100.000 population 534,80 533,23 530,80 F5 Number of acute care hospital admissions/discharges 17.715.272 17.961.536 18.257.268 F6 Acute care admissions/discharges per 100 population 21,64% 21,97% 22,33% F7 Average length of stay for acute care hospitals (bed-days) 8,20 8,10 7,90 F8 Bed occupancy rate for acute care hospitals 79,20% 79,00% 79,00% Page 6 of 7
G1 Number of General Practitioners (GPs) 53.549 53.876 53.821 G1a General Practitioners per 100.000 population 65,40 65,90 65,81 G1b Population per one GP 1.528,97 1.517,51 1.519,47 G2 Number of physicians 297.835 305.093 312.695 G2a Number of physicians per 100.000 population 363,77 373,17 382,36 G HEALTHCARE WORKFORCE G3 % of physicians working in hospitals 51,37% 51,79% 52,45% G4 Number of nurses 922.000 932.000 944.000 G4a Nurses per 100.000 population 1.126,11 1.139,96 1.154,33 G5 % of nurses working in hospitals 59,11% 59,12%... G6 Number of nurses per doctor 3,10 3,05 3,02 Page 7 of 7