Empirische und ordnungspolitische Analyse der Krankenhausinsolvenzen
Hospital insolvencies in Germany represent a controversially debated topic and a phenomenon of growing concern which has become increasingly prominent since 2022. It is important to note that the nature and reasons for insolvency vary significantly from one location to another. The analysis of hospital insolvencies reveals both expected and challenging-to-interpret results. Among the total of 61 hospital sites that filed for insolvency proceedings between July 2022 and October 2024, 13 closures have occurred to date. From the summer of 2023, the occurrence of insolvencies increased noticeably, reaching a new peak at the beginning of 2024. In 66 % of cases, (i) debtor-in-possession insolvency proceedings were initiated, followed by (ii) standard insolvency proceedings (18 %) and (iii) protective shield proceedings (16 %). Ownership type and hospital size have a measurable impact on the probability of insolvency. By contrast, socio-economic indicators present a heterogeneous and contradictory picture, making it impossible at the current state of research to determine whether hospital insolvencies contribute to an increase in socio-economically driven disparities in healthcare provision in Germany. Furthermore, the regulatory examination of cross-subsidisation of publicly owned hospitals can also be regarded as critical. The lawsuit filed by Agaplesion may have far-reaching implications for the practice of municipal subsidisation, as it seeks a landmark ruling on a financing practice that is both nationally and internationally prevalent. A solution may lie in more transparent financing models and clear incentives for efficiency improvements, irrespective of sector affiliation.
Pilny, A., A. Beivers, B. Augurzky and J. Malzahn (2025), Empirische und ordnungspolitische Analyse der Krankenhausinsolvenzen. In Jürgen Klauber, Jürgen Wasem, Andreas Beivers, Carina Mostert and David Scheller-Kreinsen (Hrsg.), Krankenhaus-Report 2025 - Versorgung Hochbetagter. Berlin/Heidelberg: Springer, 341-353.