In recent years, under the pressure of necessary reforms, a process of consolidation in the hospital sector had already been evident. Between 1991 and 2003 bed capacity fell by almost a fifth and the number of hospitals by 9 % - although the number of hospital cases rose by almost one-fifth. The average hospital stay declined from 14 to just under 9 days. Despite this enhanced performance, patients in Germany spend longer in hospital than in other countries such as Austria (8.1 days), USA (6.6) and Denmark (5.7). This has much to do with the fact that hospital remuneration is largely linked to the length of hospital stay.
The problems in the hospital sector will not be able to be solved without sweeping rationalization and modernization investment. With the federal states strapped for cash, the privatization process of public sector hospitals is bound to accelerate sooner or later.
Rising efficiency coupled with falling capacities will be the hallmarks of the hospital sector in the future as well. By 2020 we see the average hospital stay falling by a further 20 % to around seven days. As the number of beds and hospitals falls by a further one-fifth, public sector hospitals are likely to be the main losers as they have to grapple with a host of disadvantages compared with private clinics.