Investment backlog and digitalization problems in German hospitals
08.06.2020 17:23
Three out of four hospitals in Germany are not sufficiently capable of investing. The insufficient investment financing of hospitals is the main reason why between 30% and 50% of hospitals have been making losses for more than 10 years. This is the result of several DKI studies on the investment ability of German hospitals.
The main reason for the weak investment capacity is the insufficient financing of the hospitals' investment costs by the federal states. The hospitals are forced to finance the economically necessary investments themselves. Investments financed by equity reduce the operating result and even lead to the risk of loss. An insufficient investment rate causes aging and depletion of the structural and technical infrastructure of hospitals, with potentially detrimental consequences for patient care.
In fact, only half of hospital investments are covered by public funding. The hospitals contribute the other half of the required investments in other ways, for example through surpluses from service fees. However, hospitals' profit margins are usually not sufficient to cover investment needs or finance loans. Only around a quarter of hospitals have achieved sufficient returns to finance necessary investments in recent years or expect this in the future.
The underfinancing of hospital investments leads to a significant investment backlog. For the next five years, German hospitals' investment needs will be around €7 billion per year. The public funding rate from the federal states has only been €2.7 billion per year in recent years. The investment requirement is therefore two and a half times higher than the current public funding for hospital investments.
There is therefore an urgent need for action to finance the investment costs. Without a fundamental and sustainable investment financing solution, the future of hospital care will not be secured.
The investment problems with digitalization in hospitals are particularly serious. Digitalization is considered an important key to better and more efficient hospital care. Nevertheless, Germany lags behind in international comparison when it comes to digitalization in hospitals. There is a lack of financial resources for comprehensive digitalization. The IT infrastructure is partly outdated and not sufficiently networked internally and externally. Telemedical and telematic IT solutions are only used selectively.
Less than half of the hospitals have a uniform hospital-wide electronic patient record or electronic medication support or medication safety check. Telematic and telemedical applications, such as teleconsultations and telemonitoring, and IT-supported electronic decision-making in diagnostics and therapy are particularly widespread.
The potential of digitalization is recognized in German hospitals, but in many cases it has not yet been exploited. The main reason, as in other areas of the hospital infrastructure, is the hospitals' completely inadequate investment financing. Public funding is far from sufficient to finance investments. The digitization of hospitals cannot be financed from their own resources.
Comprehensive digitalization is a central building block for the future viability of German hospitals. The DKI studies conclude that a public investment program is necessary for this purpose.