CHART 6
Number of hospitals in 2016 and number of
hospitals closed (opened) since 2006. The four
clusters are grouped considering the total number
of hospitals in 2016: <100; 100>200; 200>500;
>500
Number of hospitals in 2016
Number of hospitals closed (opened) since 2006
Lithuania
-22
Ireland
-92
-41
Latvia
Estonia
-24
Slovenia
0
-2
Luxembourg
0
20
40
60
80
100
120
140
160
180
Belgium
200
-38
Hungary
-14
Slovak Republic
-16
0
25
50
75
100
125
150
175
200
225
250
-50
Switzerland
Greece
-37
+9
Austria
-88
Finland
+3
Czech Republic
+4
Portugal
0
50
100
150
200
250
300
350
Germany
400
-259
France
+182
United Kingdom
+175
Italy
-193
Poland
+229
Spain
+18
The Netherlands
occupancy rate of acute care beds.
During these years, almost all European
countries had changes in their hospital provision
patterns, and major efforts were made to deliver
better services, increase quality, and improve
efficiency and productivity. The streamlining of
care delivery started from a sharp reduction in
the size of secondary care institutions and moved
towards more integrated and efficient patterns of
care, which might result in completely
overcoming the hospital-centric model of care in
the future.
This was possible thanks to a package of
financial and organisational measures addressed
to improve coordination and integration between
the different levels of care, increase the use of
day-hospital and day-surgery and introduce new
and more efficient methodologies of hospital
financing in order to incentivise appropriateness
(for example, the replacement of daily payments
– known to encourage longer hospitalisation – by
prospective payment).
In most European countries, these policies led
to changes in the management of patients within
hospitals and offered a possibility to reduce the
number of acute care hospital beds. Only the
bed-occupancy rates, registered more disparate
trends across Europe, depending also from the
demographic and epidemiological structure of
population and from the specific organisation of
local, social and healthcare systems, i.e. the
structure of primary care, the presence and the
efficiency of a gate-keeping system, the modality
of access to secondary care, availability of home
care and development of community care.
In 2016 there were on average 2.7 hospitals for
100,000 inhabitants, ranging from 1.4 in Slovenia
to 4.8 in Finland. Moreover, there were on average
484 hospital beds for 100,000 inhabitants, ranging
from 234 in Sweden to 806 in Germany.
Between 2006 and 2016 little change in the
number of hospitals was registered in
Luxembourg (–2), Slovenia (0) and Czech Republic
(+3) (Chart 6). Major increases were registered in
the United Kingdom (+175), France (+182), Poland
(+229) and The Netherlands (+350). Major
decreases were registered in Germany (–259), Italy
(–193) and Ireland (–92).
In the same period, the total number of
hospital beds decreased by 14% ranging from
–41% in Finland (which means 302 beds cut every
100,000 inhabitants) and –3% in Germany (which
means 24 beds cut every 100,000 inhabitants)
(Chart 7). Positive variations have been registered
in Poland (+2%), Austria (+2%) and Luxembourg
(+4%). In Poland, the total number of hospital beds
per 100,000 increased of 17 units. In Luxembourg
and Austria, such increase corresponded to a
reduction of the total number of beds per
+350
0
500
1000
1500
2000
2500
3000
3500
4000
Between 2006 and 2016, the
number of hospitals decreased in
most of the countries, while the
number of hospital beds decreased
by approximately 9%
7
HHE 2019 | hospitalhealthcare.com