HHE HOPE 2019 - Page 7

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