Healthcare resource statistics - beds

Data extracted in July 2018.

Planned article update: August 2019.

Highlights

Among EU Member States, Germany had the highest number of hospital beds relative to population size in 2016.

In recent years most EU Member States have reported a decrease in the availability of hospital beds.

Ireland reported a higher rate for curative care beds occupancy in 2016 than any other EU Member State.

Curative care beds in hospitals, 2016

This article presents an overview of European Union (EU) statistics related to the availability and occupancy of hospital beds as well as the availability of long-term care beds in nursing and residential care facilities. Hospital beds include beds for curative care, long-term care and rehabilitative care.

This article is one of a set of statistical articles concerning healthcare resources in the EU which forms part of an online publication on health statistics.

Full article

Hospital beds

In 2015, there were 2.6 million hospital beds available for use across the EU-28. Approximately three quarters of these were for curative care, while the largest share of the remainder were beds for rehabilitative care, followed by beds for long-term care and beds for other purposes. Recent methodological changes in the classification of hospital beds have included psychiatric beds among the various categories of beds, however, in most countries they are also accounted for separately (see Table 1).

Table 1: Hospital beds by type of care, 2016
Source: Eurostat (hlth_rs_bds)

Germany had the highest number of hospital beds relative to population size

Among the EU Member States, Germany recorded not only the highest number of hospital beds (664 000) in 2016, but also the highest number relative to population size, with 806 hospital beds per 100 000 population — see Table 1. Austria, Bulgaria and Hungary also recorded 700 hospital beds or more per 100 000 inhabitants. The average for the EU-28 as a whole in 2015 was 514 hospital beds per 100 000 inhabitants. Spain, Ireland (other than psychiatric care beds, excludes beds in the private health sector), Denmark, the United Kingdom (excludes beds in the private health sector) and Sweden recorded the lowest numbers of hospital beds relative to their population size in 2016, all under 300 beds per 100 000 inhabitants

The share of curative care beds among all hospital beds (no data for the United Kingdom) was highest in Cyprus (100 %), while curative care beds accounted for more than 90 % of all beds in Denmark, Portugal, Slovenia, Ireland and Sweden; note that in Slovenia and Sweden the value for curative care beds includes all psychiatric care beds (whether curative or not). By contrast, less than two thirds of all hospital beds were for curative care in Croatia, Czechia, Hungary, Latvia and France (where the lowest share was recorded, at 51.9 %). In most EU Member States (no data for Portugal or the United Kingdom), long-term care beds accounted for less than 20 % of the total number of hospital beds, with only Finland (24.1 %), Hungary (25.3 %) and Czechia (28.2 %) reporting higher shares.

Decreasing availability of hospital beds in most EU Member States

Between 2011 and 2016, the number of hospital beds in the EU-28 decreased by about 3 %. Across the vast majority of EU Member States, the total number of hospital beds also generally declined, sometimes at a rapid pace. The largest contractions in the number of hospital beds were recorded in Estonia, the Netherlands (2012-2016), Denmark and Lithuania where bed numbers fell by 12-15 % and Finland where bed numbers fell by 26.6 %. There were seven Member States where the number of hospital beds rose between 2011 and 2016: in five of these — Austria, Czechia, Luxembourg, Romania and Ireland — the gains were relatively modest, whereas larger increases were recorded for Bulgaria (up 9.3 %) and Malta (up 16.6 %).

Figures 1 to 3 provide an analysis of the change between 2011 and 2016 in the availability (relative to the size of population) for three types of hospital beds. These changes in the number of hospital beds can be compared with changes in the average length of stays for in-patients and the number of hospital discharges in order to analyse developments in the supply of and demand for hospital beds.

There were only five EU Member States (no data for the United Kingdom) that recorded an increase in their number of curative care beds in hospitals (relative to the size of their population) between 2011 and 2016: there was a marginal increase in Poland (note there is a break in series), while bed numbers per 100 000 inhabitants rose at a faster pace in the Netherlands (an increase of 40.1 beds per 100 000 inhabitants; note there is also a break in series), Bulgaria (56.7 beds), Romania (58.7 beds) and Malta (83.4 beds; note there is also a break in series). During the period under consideration, Austria, Denmark and Lithuania (note there is a break in series for Denmark) saw their respective number of curative beds diminish by more than 50 beds per 100 000 inhabitants (see Figure 1).

Figure 1: Curative care beds in hospitals, 2011 and 2016
(per 100 000 inhabitants)
Source: Eurostat (hlth_rs_bds)

Rehabilitative care beds accommodate hospital patients with the intent to stabilise, improve or restore impaired body functions and structures. The number of rehabilitative beds relative to population size increased in a majority (15) of the 23 EU Member States for which data are available (see Figure 2 for details of the data coverage) during the period 2011-2016; note there were no rehabilitative care beds in Cyprus in either 2011 or 2016. The number of beds increased by more than 10 beds per 100 000 inhabitants in Poland (note there is a break in series), Austria, Romania, Bulgaria and Luxembourg (where the highest increase was recorded, an additional 54.0 beds per 100 000 inhabitants). By contrast, the number of rehabilitative care beds relative to population size decreased in eight Member States between 2011 and 2016. Reductions were generally no greater than 2.0 beds per 100 000 inhabitants, although a higher number of bed losses was reported for Finland (down 5.4 beds), Hungary (down 7.7 beds) and Germany (down 7.9 beds).

Figure 2: Rehabilitative care beds in hospitals, 2011 and 2016
(per 100 000 inhabitants)
Source: Eurostat (hlth_rs_bds)

Among the 25 EU Member States for which information is available (incomplete data for Greece; no data available for Portugal or the United Kingdom), there was a mixed development to the number of long-term care beds per 100 000 inhabitants during the period 2011 to 2016. Aside from the three Member States that did not have any long-term care beds in hospitals — Germany, Cyprus and Luxembourg — there were 13 which reported a decrease in their number of long-term care beds relative to population size and nine where there was an increase. The largest fall in the number of long-term care beds per 100 000 inhabitants was recorded in Finland, where this ratio fell by more than half, dropping from 209 beds in 2011 to 96 beds in 2016. There was also a relatively large reduction recorded in Estonia (a decrease of 23 long-term care beds per 100 000 inhabitants; note there is a break in series). By contrast, there were double-digit increases in long-term care bed numbers in Bulgaria (13 additional beds per 100 000 inhabitants) and in Austria (16 additional beds), while long-term care beds were introduced to hospitals in the Netherlands (rising from 0 to 32 beds per 100 000 inhabitants; note that there is a break in series) and there were larger increases in Czechia (38 additional beds ) and Malta (44 additional beds; note that there is also a break in series).

Figure 3: Long-term care beds in hospitals, 2011 and 2016
(per 100 000 inhabitants)
Source: Eurostat (hlth_rs_bds)

Most EU Member States reported an increase in the number of beds in for-profit private hospitals

Table 2 provides an analysis of the number of hospital beds based on the type of hospital ownership. Publicly-owned hospitals are those under the ownership or control of a government unit or another public corporation. Privately-owned hospitals may be distinguished as either not-for-profit (no financial gain for the unit(s) that establishes, controls or finances them) or for-profit.

Table 2: Hospital beds by type of ownership, 2011 and 2016
Source: Eurostat (hlth_rs_bds2)

In 2016, at least 9 out of every 10 hospital beds in Slovenia, Lithuania, Croatia, Finland, Romania, Malta, Denmark, Estonia and Latvia were in publicly-owned hospitals. At the other end of the range, all of the hospital beds in the Netherlands were in the private sector (not-for-profit), while a majority (59 %) of the hospital beds in Germany were in privately-owned hospitals. Aside from these two countries, the lowest shares of beds in publicly-owned hospitals were found in Cyprus (54 %), France (62 %) and Greece (65 %).

In absolute terms, the largest number of hospital beds in for-profit private hospitals was in Germany where there were 201 000such beds in 2016, more than double the next highest number, 97 000 in France; note that there are no data available for the United Kingdom. There were an additional 193 000 beds in Germany in not-for-profit private hospitals, which was also the highest number recorded among the EU Member States, followed by the special case of the Netherlands, where the entire stock of hospital beds (62 000 beds) was in the not-for-profit private sector, and France (57 000 beds).

Across the 19 EU Member States for which data are available for both 2011 and 2016 (see Table 2 for coverage), the development of the number of beds in for-profit private hospitals was mixed. There was an expansion in the number of beds in 11 Member States, most notably in Malta and Lithuania where the number of hospital beds in for-profit private hospitals more than doubled, while there was also relatively fast growth in the number of beds in such hospitals in Romania, Croatia, Bulgaria and Portugal. In absolute terms, the largest increases in bed numbers were in Bulgaria and Romania where for-profit private hospitals added 5 300 and 3 300 beds between 2011 and 2016.

Highest curative care beds occupancy rates in Ireland

Among the EU Member States (see Figure 4 for data availability), the occupancy rate of curative care beds in 2016 ranged from 65 % in Portugal to 83 % in Belgium, with the Netherlands (59 %) below this range and Ireland (94 %) above it. There was no clear pattern among the Member States with respect to the change in occupancy rates between 2011 and 2016. Among the 20 Member States for which data are available: 13 recorded an increase, while the other seven saw their rates decline. In percentage point terms, the largest increase in occupancy rates between 2011 and 2016 was recorded in the Netherlands, while the largest decrease was in Cyprus (note there is a break in series).

Figure 4: Curative care bed occupancy rate in hospitals, 2011 and 2016
(%)
Source: Eurostat (hlth_co_bedoc)

Long-term care beds in nursing and residential care facilities

The number of long-term care beds in nursing and residential care facilities relative to population size increased in most EU Member States

While the analysis presented so far has focused on beds in hospitals, this final section looks at beds in nursing and residential care facilities. In 2015, there were 3.6 million long-term care beds in nursing and residential care facilities in the 23 EU Member States where data was available (2014 data for Slovakia, 2013 data for France; no recent data available for Belgium and Denmark; no data available for Cyprus, Portugal and Slovenia). Relative to population size, the highest numbers of long-term care beds in such facilities were recorded in the Netherlands, Sweden, Luxembourg, Belgium (2010 data) and Finland, with 1 200 - 1 300 beds per 100 000 inhabitants (see Figure 5), while Germany and Malta also recorded in excess of 1 000 beds per 100 000 inhabitants. In most of the remaining Member States for which data are available, the number of long-term care beds in nursing and residential care facilities ranged from 400 - 1 000 per 100 000 inhabitants. There were six Member States that reported fewer than 400 such beds per 100 000 inhabitants, with Bulgaria (33 beds per 100 000 inhabitants) and Greece (17 beds per 100 000 inhabitants) reporting the lowest ratios.

Figure 5: Long-term care beds in nursing and residential care facilities, 2010 and 2015
(per 100 000 inhabitants)
Source: Eurostat (hlth_rs_bdsns)

A comparison between 2010 and 2015 reveals that there was an increase in long-term care bed numbers per 100 000 inhabitants in most of the EU Member States for which data are available. Relative to population size, the number of long-term care beds in nursing and residential care facilities fell marginally in the United Kingdom, while the reductions in Latvia and Bulgaria were somewhat larger. However, by far the biggest reduction in long-term care beds was recorded in Sweden (note there is a break in series), where there were 141 fewer beds per 100 000 inhabitants in 2015 than in 2010. Among the 19 Member States which reported an increase between 2010 and 2015 in their number of long-term care beds in nursing and residential care facilities relative to population, there were increases of more than 100 additional beds per 100 000 inhabitants in Slovakia (2010-2014), Estonia, the Netherlands (note there is a break in series), Spain (excludes beds for palliative care) and Luxembourg (note there is also a break in series).

Source data for tables and graphs

Data sources

Key concepts

Hospitals comprise licensed establishments primarily engaged in providing medical, diagnostic and treatment services that include physician, nursing, and other health services to in-patients and the specialised accommodation services required by in-patients. Hospitals may also provide out-patient services as a secondary activity. Speciality hospitals, including mental health and substance abuse hospitals, are also covered.

Long-term care institutions refer to nursing and residential care facilities which provide accommodation and long-term care as a package. Beds in nursing and residential care facilities are recorded separately from hospital beds.

Hospital beds are those beds which are regularly maintained and staffed and immediately available for the care of admitted patients; both occupied and unoccupied beds are included. Excluded are recovery trolleys and beds for same day care (day care and out-patient care), provisional and temporary beds. The following descriptions refer to the classification of hospital beds by type of care:

Total hospital beds = curative (acute) care beds + rehabilitative care beds + long-term care beds + other hospital beds

  • Curative care beds in hospitals are for patients where the principal clinical intent is to do one or more of the following: manage labour (obstetric), perform surgery, cure or treat (including relieving symptoms, reducing severity, or protecting against exacerbation and/or complication) non-mental illness or injury, perform diagnostic or therapeutic procedures. They include beds for psychiatric and non-psychiatric curative (acute) care, from general hospitals, mental health hospitals and other specialised hospitals. Beds for palliative and long-term nursing care are recorded under long-term care.
  • Rehabilitative care beds in hospitals are beds accommodating patients with the principal intent to stabilise, improve or restore impaired body functions and structures, compensate for the absence or loss of body functions and structures, improve activities and participation and prevent impairments, medical complications and risks. They include beds for psychiatric and non-psychiatric curative (acute) care, from general hospitals, mental health hospitals and other specialised hospitals.
  • Long-term care beds in hospitals are for patients requiring long-term care due to chronic impairments and a reduced degree of independence in activities of daily living, including palliative care. They include beds for psychiatric and non-psychiatric curative (acute) care, from general hospitals, mental health hospitals and other specialised hospitals.
  • Other beds include all other beds in hospitals not elsewhere classified.

Psychiatric care beds in hospitals are for patients with mental health problems. Included are all beds in mental health and substance abuse hospitals, as well as beds in psychiatric departments of general and specialty hospitals. Beds for long-term nursing care in mental health and substance abuse hospitals are recorded under psychiatric care beds. Beds for palliative care are recorded under long-term care. Until recently these beds where classified in a separate category within the data collection on hospital beds. As of July 2016 all published data referring to psychiatric beds are included in the other categories according to the healthcare that each patient receives (curative, rehabilitative, long-term care or other), although the aggregate for all psychiatric hospital beds continues to be published separately.

Healthcare resources and activities

Statistics on healthcare resources (such as beds in hospitals as well as nursing and residential care facilities) are documented in this background article which provides information on the scope of the data, its legal basis, the methodology employed, as well as related concepts and definitions.

For country specific notes on this data collection, please refer to these background information documents:

Note on tables: the symbol ':' is used to show where data are not available.


Context

Indicators concerning the number and type of hospital beds complement information on hospital personnel and equipment to provide an overview of the resources available for delivering healthcare in hospitals. The European core health indicators (ECHI) shortlist includes an indicator on ‘hospital beds’ by type of bed in the chapter on health services. It should be noted that the information on hospital beds only covers beds for in-patient care: many hospitals also provide day care and out-patient care and beds used for these services are excluded from the information presented.

In many areas, technological developments have reduced the average length of stay for in-patient procedures or replaced procedures requiring in-patient care with ones that can be provided to day care or out-patients. As such, it is commonplace to find the total number of available hospital beds being reduced across most of the EU Member States.

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Health care resources (hlth_res)
Health care facilities (hlth_facil)
Hospital beds by type of care (hlth_rs_bds)
Hospital beds by hospital ownership (hlth_rs_bds2)
Hospital beds by NUTS 2 regions (hlth_rs_bdsrg)
Long-term care beds in nursing and residential care facilities by NUTS 2 regions (hlth_rs_bdsns)
Health care activities (hlth_act)
Curative care bed occupancy rate (hlth_co_bedoc)