Strengths and Weaknesses of Financing Hospitals in Germany

In this study strengths and weaknesses of financing hospitals in the German health care sector are examined. In the first part of the paper key data of hospitals, subsidies granted by federal states to hospitals, allocation of expenses in the statutory and private health sector are examined. Moreover, in the same part precautions taken in the German health care industry are analyzed. In the second part of the study compensation system, in particular Diagnosis Related Groups, as a financial resource for the activities performed in hospitals are investigated. For comparison the system before 2003 is also considered. In the third part critical view of the dual system in Germany is discussed. Change in financing of hospitals from 2003 shows improvement in financial situation of these institutions in Germany. However, the new implemented dual system reveals deficits in investment expenditures supported by federal states. The monistic model proposed by Rürup for a financing system from a single resource may provide a better financial base for well-equipped hospitals to meet the challenges among the competitive German hospitals.