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MS75060 MSI HEALTHCARE: GERMANY: OCTOBER 2000

- English language version

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TABLE OF CONTENTS

Table of Contents
1 Executive Summary 1
2 INTRODUCTION 2
2.1 Definitions 2
2.2 Methodology 4
2.3 The German Economy 4
2.4 Exchange Rates 6
2.5 Abbreviations 6
3 MARKET Size 8
3.1 Market Overview and Trends, 1995-1999 8
3.2 Factors Affecting The German Healthcare System 9
3.2.1 Legislation 9
3.2.2 The Ageing Population 10
3.3 Market Segmentation, 1995-1999 13
3.3.1 By Type Of Contributor 13
3.3.1.1 Compulsory Medical Insurance 15
3.3.1.2 Employers 22
3.3.1.3 Public Sector Spending 23
3.3.1.4 Private Households 23
3.3.1.5 Pension Insurance 26
3.3.1.6 Compulsory Public And Private Nursing Insurance 27
3.3.1.7 Private Medical Insurance (PMI) 32
3.3.1.8 Compulsory Accident Insurance 41
3.3.2 Market Size By Type Of Cost 43
3.3.2.1 Treatment 45
3.3.2.2 Costs Resulting From Sickness 46
3.3.2.3 Prevention And Care Measures 48
3.3.2.4 Training And Research 50
3.3.2.5 Other Healthcare Costs 50
3.4 Forecast Market Size, 2000-2004 51
3.4.1 Overview 51
3.4.2 By Type Of Cost 54
3.4.2.1 Treatment 55
3.4.2.2 Costs Resulting From Sickness 55
3.4.2.3 Prevention And Care Measures Expenditure, 2000?2004 56
3.4.2.4 Training And Research Expenditure, 2000?2004 57
4 Hospitals and Rehabilitation Units 58
4.1 Market Size, 1995-1999 58
4.2 Factors Affecting Demand 59
4.2.1 Market Segmentation 61
4.2.1.1 By Number Of Sites 61
4.2.1.2 By Type Of Ward 64
4.2.1.3 By Type Of Operator 66
4.2.1.4 Number Of Sites By Region 68
4.2.1.5 Number Of Beds By Region 69
4.3 Market Forecasts, 2000-2004 71
4.3.1 Overview 71
4.3.2 Number Of Hospitals And Rehabilitation Units And Beds 72
5 Nursing and Residential Homes 76
5.1 Market Size, 1995?1999 76
5.2 Factors Affecting Demand 77
5.3 Market Segmentation 79
5.3.1 By Number Of Homes And Beds 79
5.3.2 By Operator 80
5.3.3 Number Of Beds By Region 81
5.3.4 Short Term And Part Time Care Facilities 84
5.4 Market Forecasts, 2000-2004 86
5.4.1 Overview 86
5.4.1.1 Forecast Number Of Homes And Beds 87
6 Out-Patient Treatment 89
6.1 Overview 89
6.1.1 Doctors 89
6.1.1.1 Overview 89
6.1.1.2 Number Of Doctors Active In The German Out-Patient Sector 91
6.1.1.3 Forecast German Expenditure On Out-Patient Treatment By Doctors 92
6.1.2 Dentists 93
6.1.2.1 Expenditure, 1995?1999 93
6.1.2.2 Forecast Expenditure, 2000?2004 95
7 Medication, Medical Aids And Other Treatment 97
7.1 Expenditure, 1995?1999 97
7.2 Forecast Expenditure, 2000?2004 100
8 OPPORTUNITIES FOR SUPPLIERS 102
9 MAGAZINES 104
10 Trade Associations 105
List of Tables
1.     Economic Indicators On The German Economy, 1991-2001 6
2.     Expenditure On Healthcare In Germany, 1995-1999 8
3.     Age Distribution Of Germany's Resident Population, By Age Group, 1995-1999 11
4.     Forecast Age Distribution Of Germany's Resident Population, By Age Group, 2000-2025 11
5.     Expenditure On Healthcare In Germany, By Type Of Contributor, 1995-1999 15
6.     Contributions To The German Healthcare System By The Compulsory Medical Insurance Sector, 1995-1999 16
7.     Surplus/Deficit Of The Compulsory Medical Insurance Sector 1995-1999 17
8.     Contributions To The German Healthcare System By The Compulsory Medical Insurance Sector, By Type Of Healthcare Cost, 1995-1999 18
9.     Compulsory Medical Insurance Premiums, 1995-1999 19
10.  Number Of Compulsory Medical Insurance Policy Holders, 1995-1999 20
11.  Number Of Compulsory Medical Insurance Companies, 1970-1999 21
12.  Contributions To The German Healthcare System By Employers, 1995-1999 22
13.  Contributions To The German Healthcare System By The Public Sector, 1995-1999 23
14.  Contributions To The German Healthcare System By Private Households, 1995-1999 24
15.  Contributions To The German Healthcare System By Private Households, By Type, 1999 25
16.  Contributions To The German Healthcare System By The Pension Insurance Sector, 1995-1999 27
17.  Contributions To The German Healthcare System By The Compulsory Public And Compulsory Private Nursing Insurance Sector, 1995-1999 28
18.  Levels Of Contributions For Patients Depending On Their Stage Of Care, 1999 29
19.  Contributions To The German Healthcare System By The Compulsory Nursing Insurance Sector, By Type Of Cost, 1995-1999 30
20.  Contributions To The German Healthcare System By The PMI Sector, 1995-1999 33
21.  Contributions To The German Healthcare System By The PMI Sector, By Type Of Treatment, 1995-1999 34
22.  Private Medical Insurance Premiums, 1995-1999 35
23.  Private Medical Insurance Premiums, By Type Of Insurance, 1995-1999 36
24.  Number Of German Private Medical Insurance Policy Holders, 1995-1999 37
25.  Number Of German Comprehensive PMI Policy Holders, 1995-1999 37
26.  People Changing Between Comprehensive Private Medical Insurance And Compulsory Medical Insurance In Germany, 1995-1999 39
27.  Number Of German Partial PMI Policy Holders, 1995-1999 40
28.  Market Shares In The Private Medical Insurance Market, Total Gross Income From Members’ Subscriptions And percent Of Total, 1998 41
29.  Contributions To The German Healthcare System By The Compulsory Accident Insurance Sector, 1995-1999 42
30.  Contributions To The German Healthcare System By The Compulsory Accident Insurance Sector, By Type, 1999 42
31.  Contributions To the German Healthcare System, By Type Of Cost, 1995-1999 44
32.  Expenditure On Treatment In The German Healthcare System, By Type Of Treatment, 1995-1999 46
33.  German Costs Resulting From Sickness, 1995-1999 47
34.  German Costs Resulting From Sickness, By Type Of Expenditure, 1995-1999 48
35.  German Expenditure On Prevention And Care Measures, 1995-1999 49
36.  German Expenditure On Training And Research, 1995-1999 50
37.  German Expenditure On Other Healthcare Costs, 1995-1999 51
38.  Forecast Expenditure On Healthcare In Germany, 2000-2004 51
39.  Forecast Contributions To the German Healthcare System, By Type Of Cost, 2000-2004 55
40.  Forecast Expenditure On Treatment In The German Healthcare System, 2000-2004 55
41.  Forecast German Costs Resulting From Sickness, 2000-2004 56
42.  Forecast German Expenditure On Preventative And Other Care Measures, 2000-2004 57
43.  Forecast German Expenditure On Training And Research, 2000-2004 57
44.  German Expenditure On Hospitals And Rehabilitation Units, 1995-1999 58
45.  Number Of Cases, Average Stay And Utilisation Of Capacity, 1990-1999 62
46.  Number Of German Hospitals And Rehabilitation Units, 1995-1999 64
47.  Number Of Beds In German Hospitals And Rehabilitation Units, 1995-1999 64
48.  Beds In German Hospitals, By Type Of Ward, 1999 65
49.  Beds In German Rehabilitation Units, By Type Of Ward, 1999 66
50.  German Hospitals And Rehabilitation Units, By Type Of Operator, 1995-1999 67
51.  Regional Distribution Of Hospitals And Rehabilitation Units In Germany, 1995-1999 69
52.  Regional Distribution Of Beds In Hospitals And Rehabilitation Units In Germany, 1995-1999 70
53.  Forecast German Expenditure On Hospitals And Rehabilitation Units, 2000-2004 72
54.  Forecast Number Of German Hospitals And Rehabilitation Units, 2000-2004 73
55.  Forecast Number Of Beds In German Hospitals And Rehabilitation Units, 2000-2004 74
56.  German Expenditure On Nursing And Residential Homes, 1995-1999 76
57.  Number Of German Nursing And Residential Homes, 1995-1999 80
58.  Number Of German Nursing And Residential Homes, By Type Of Operator, 1995-1999 81
59.  Regional Distribution Of Beds In Nursing And Residential Homes In Germany, 1995-1999 84
60.  German Short Term And Part Time Care Facilities, 1995-1999 85
61.  German Short Term Nursing Homes, By Type Of Operator, 1997 86
62.  Forecast German Expenditure On Nursing And Residential Homes, 2000-2004 87
63.  Forecast Number Of Nursing And Residential Homes And Beds, In Germany, 2000-2004 88
64.  Contributions To The German Healthcare System By Out-Patient Treatment, 1995-1999 89
65.  German Healthcare Expenditure On Out-Patient Treatment By Doctors, 1995-1999 90
66.  Number Of Practising Doctors In Germany, By Type, 1995-1999 91
67.  Forecast German Expenditure On Out-Patient Treatment By Doctors, 2000-2004 93
68.  German Expenditure On Out-Patient Treatment In Dentists' Surgeries, 1995-1999 94
69.  Number Of Practising Dentists In Germany, 1995-1999 94
70.  Forecast German Expenditure On Out-Patient Treatment In Dentists' Surgeries, 2000-2004 96
71.  German Expenditure On Medication, Medical Aids And Other Treatment, 1995-1999 97
72.  German Expenditure On Medication, Medical Aids And Other Treatment, By Type Of Expenditure, 1995-1999 99
73.  Regional Distribution Of Chemists In Germany, 1999 100
74.  Forecast German Expenditure On Medication, Medical Aids And Other Treatment, 2000-2004 101
List of Diagrams
1.     Contributions To The German Healthcare System, By Type Of Cost, 1999 45
2.     Number Of Cases, Average Stay And Utilisation Of Capacity, 1990-1999 63
3.     German Hospitals And Rehabilitation Units, By Type Of Operator, 1992-1999 68

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EXECUTIVE SUMMARY

MSI believe that German expenditure on healthcare increased by 4 percent between 1995 and 1999 to reach a total value of DM528.0 billion (€270.0 billion). Major factors which have influenced German healthcare expenditure include the ageing of the population, rises in the cost of healthcare, investment in medical equipment and improved medication.

MSI estimate that German expenditure on treatment totalled DM329.8 billion (€168.6 billion) in 1999. Treatment costs represented 62 percent of the total spending on healthcare in Germany in 1999. Costs for in-patient treatment rose by 16 percent between 1995 and 1999 to reach a value of DM141.8 billion (€72.5 billion). Spending on out-patient treatment increased by 7 percent to a value of DM111.3 billion (€56.9 billion) in 1999. Costs for medication, medical aids and other treatment increased by as much as 19 percent to a total value of DM76.7 billion (€39.2 billion).

Trade sources report that the main factors affecting the German healthcare market include the following:

· changes in legislation
· technical and pharmaceutical advances
· increasing prices and wage increases
· the ageing population

Between 1995 and 1999 the number of hospitals in Germany fell by 4 percent and there were 7 percent fewer hospital beds. MSI forecast that the number of hospitals and hospital beds will continue to decline, at 4 percent and 8 percent respectively between 2000 and 2004.

MSI has identified a number of opportunities for suppliers to the German healthcare system which are expected to occur during the forecast period. In particular, electronic communications will play an important role in the German healthcare system in the future. Indeed, it is expected that investment will be made in this area in order to further improve the efficiency of German healthcare establishments.

Text © 2001 MSI

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Last updated by Paul Tucker 20th March 2001