More health care provided with fewer hospital beds
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In the period 1972-2006, the number of beds and patient days in general and university hospitals declined considerably. Simultaneously, the number of hospital admissions and treatment and nursing staff increased. Yet, the share of personnel costs in total operating costs is diminishing.
Hospital stay after admission reduced by more than half
In the period 1972–2006, the number of hospital admissions grew by 143 percent. The number of hospital beds decreased by 30 percent over the same period. The number of patient days dropped by 41 percent. As a result, the average stay after admission was considerably shorter in 2006 than in 1972: the average hospital admission period including overnight stay dropped from 17 to 7 days.
Patients are more often treated in an outpatient setting without spending one or more nights in hospital. In 1990, 21 percent of hospital admissions were dealt with in outpatient clinics, as against 46 percent in 2006.
Hospital beds, admissions and patient days
More staff involved in treatment and nursing
In 2006, more hospital staff are engaged in patient-oriented health care than in 1973. It concerns, for instance, nursing staff, but also medical specialists in paid employment, laboratory technicians and student nurses. Hospital staff (expressed in full-time equivalents) rose by 60 percent. If the decline in patient days is taken into account, the number of treatment and nursing staff per patient day has almost tripled.
This means that, compared with the past, the admission period and the intensity level of the treatment have gone up. Patients are also more often treated on an inpatient instead of an outpatient basis. The staff increase in university hospitals is partly caused by the fact that since 1999 medical specialists in this category of hospitals are working in payroll employment. In other hospitals, medical specialists will often work in partnerships.
Patient-oriented staff
Share personnel costs down
Non-patient-oriented staff also increased, yet the share of personnel costs in total operating costs was reduced from over 70 percent in 1972 to over 60 percent in 2006. The costs of research, medicines and medical equipment, on the other hand, have doubled since 1998.
Share personnel costs in operating costs
The share of staff costs in university hospitals is higher than in general hospitals. One of the reasons is that university hospitals offer a wide variety of training programmes.
Rudi Bakker