The most important thing in brief:
People with a high level of care are particularly affected – i.e. people who are already more disadvantaged
Lea Bergmann
- If older patients are dependent on a nursing home place after their hospital treatment, they often cannot find a place. So that those affected can receive further care, they remain in the hospital. The result: hospital beds are blocked. Nursing homes are legally obliged to comply with minimum staffing requirements and often there are not enough staff available. The nursing home capacities are therefore not sufficient to ensure the care of those affected after treatment in hospital.
- As a result of the lack of nursing home places, those affected remain in hospital for an average of three to four additional days. This increases the length of stay in hospital by around 40%. This extended stay leads to additional hospital costs of around 400 euros per patient. Due to the flat rates per case, the billable costs decrease as the length of stay increases, which is why the actual hospital costs incurred are likely to be significantly higher.
- Regions with few nursing home places and a high staff shortage are particularly affected. In these areas, the likelihood of patients staying in hospital unnecessarily long is particularly high. The length of stay here can be another 0.5 days longer than in regions with better care provision.
- Patients requiring a higher level of care are particularly disadvantaged. Due to the shortage of staff, nursing homes apparently prefer to accept people with lower care needs because they require less care. This means that those most in need of care have to wait the longest in hospital for a place.
- The study is based on extensive health data from a large German health insurance company, data from nursing statistics and regional data at district level. The investigation period ranges from 2011 to 2019.
“Our study results show that the lack of nursing home places and qualified nursing staff not only extends the length of stay of hospital patients, but also significantly increases hospital costs,” says health economist Lea Bergmann from RWI – Leibniz Institute for Economic Research. “In order to counteract the nursing shortage and relieve the burden on overburdened hospitals, urgent measures should be taken to train and recruit nursing staff – including from abroad. Because: The staff shortages in nursing have a significant impact on the well-being of those affected. People with a high level of care are particularly affected – i.e. people who are already more disadvantaged.”
Those: Leibniz Institute for Economic Research
1. Introduction – Welcome, Dr. Bergmann. We appreciate you taking the time to talk to us about your findings on the impact of nursing home capacity and staffing shortages on hospital stays. Can you start by explaining the main findings of your study and how they relate to the current situation in Germany’s healthcare system?
2. Importance of Nursing Home Places – Dr. Bergmann, your report suggests that nursing home places play an essential role in reducing hospital stays. Can you elaborate on why this is the case? What makes nursing homes an important part of the continuum of care for patients who no longer require hospitalization?
3. Challenges Faced by Nursing Homes – You emphasize that nursing homes are legally obligated to meet minimum staffing requirements, which can sometimes lead to insufficient staffing levels. How does this affect the quality of patient care in nursing homes? Are there any measures in place to address the staffing shortages in these facilities?
4. Impact on Patients with High Care Needs – Your study reveals a disproportionate impact on patients with high care needs who often have to wait longer for a nursing home place. Can you discuss the reasons behind this? How should the healthcare system ensure that these individuals receive adequate care while they wait for a nursing home placement?
5. Regional Disparities – Regions with fewer nursing home places and higher staff shortages seem to have longer hospital stays. What factors contribute to these regional disparities? Is there anything that policy makers can do to address them?
6. Costs and Consequences – The study shows that the extended hospital stay due to lack of nursing home places leads to additional hospital costs of around 400 euros per patient. How does this impact the overall healthcare system financially? Are there any other unintended consequences of this situation that we should be aware of?
7. Way Forward – As someone working in health economics, what policy recommendations do you have for improving the situation? What steps should be taken to address the nursing shortage and ensure that hospital beds are used efficiently?
8. Conclusion – Thank you for your insights, Dr. Bergmann. In your opinion, what is the most critical aspect of this
