In the pursuit of business in the growing health care industry, many regions are striving to position themselves as leading, supraregional health care centers. An analysis of patient "migration" provides information as to which cities have been particularly successful in this competition. The top positions are occupied by Munich, Frankfurt am Main, Heidelberg and the urban centers in the Ruhr Region. If one takes the size of the particular catchment areas into account, then Heidelberg takes first place, followed at a considerable distance by Regensburg, Ulm and Passau.

The results ...

When an urgent need for hospitalization arises, patients will usually turn to a facility near home. When it's a matter of special treatment, however, individual hospitals can also develop drawing power beyond the immediate region. That is why, by analyzing patient migration, one can measure the appeal of an individual hospital or the facilities in a health care cluster. Here Munich occupies first place, before Frankfurt am Main, when measuring the significance of a region as a health care center in an absolute ranking based on the differential between patient influx and efflux. Surprising here is that Heidelberg, with its relatively small population, takes third place, followed closely by the urban centers in the Ruhr Region and by the city of Hamburg. Bonn and Münster take places six and seven. Berlin, surprisingly, does not appear until eighth place.

If in a second step influx is set in relation to the total number of patients in a given region, then one can avoid the hazard of individual regions assuming a top-ranking position simply on the basis of their population density. In this relative ranking Heidelberg takes first place, followed at a considerable distance by Regensburg, Ulm and Passau. Koblenz, Freiburg and Bayreuth occupy places five through seven. Oldenburg, Darmstadt and Ansbach follow. Münster and Bonn also make their way into the front-running positions. Beaten out in this comparison are, as expected, the high-population conurbations.

... and their significance

These rankings offer patients reference points for estimating the attractiveness of various health care centers when deciding where to seek treatment.

These patient migration patterns are of major significance for the individual hospitals since the information makes it possible to draw conclusions about medical attractiveness.

Policy makers at the federal level can use this data as a basis for defining centers where high-end medicine is practiced.

Regional policy makers can measure the success of projects on the basis of whether the placement for the particular health care center improves over the course of time.

Method and data basis

To arrive at clear statements as to which regions can justifiably lay claim to the status of a "health care center", 94 regional health care clusters were identified on the basis of patient movements. They were then ordered, in two separate rankings, according to their attractiveness for patients. The values for the year 2005 were compared with the data for 1996 so as to make statements about changes over the course of time.

Regions were demarcated on the basis of a complete patient survey, including about 17 million cases and conducted in 2005. This data was readied for use by the Research Data Center of the State Statistical Offices. Health care centers were defined in a first step by the fact that patient influx exceeds patient efflux (positive net migration). Regions with negative net migration are designated as the "periphery". In a second step the individual peripheral areas were assigned to the centers to define the most tightly integrated regions possible - at least in regard to patient migration. The peripheral areas were assigned to the center that showed the strongest influx of patients from any given residential area.

For further information, please contact:
Dr. Boris Augurzky (RWI Essen and HCB), Phone:+49 201 8149-203, e-mail
Dr. Sebastian Krolop (ADMED GmbH), Phone:+49 163 744 4031,
Joachim Schmidt ( RWI Press Office), Phone: +49 201 8149-292, e-mail Nils aus dem Moore (RWI Press Office, Berlin Bureau), Phone:+49 30 202 1598 15

This study was undertaken in conjunction with the "Krankenhaus Rating Report 2008: Qualität und Wirtschaftlichkeit", which has been published by RWI Essen, the Institute for Health Care Business GmbH and the ADMED GmbH.