Healthcare resource statistics - beds

Data extracted in August 2020.

Planned article update: August 2021.

Highlights

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

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

In 2018, Ireland reported a higher rate of occupancy for curative care beds than any other EU Member State.

Curative care beds in hospitals, 2018

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 health statistics.

Full article

Hospital beds

In 2018, there were 2.4 million hospital beds available for use across the EU-27. Almost three quarters of these were for curative care, while the largest share of the remainder was 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 care beds among the various categories of beds (curative, rehabilitative, long-term care and other). However, a separate sub-total for psychiatric care beds (across all four categories) is also available (see Table 1).

Table 1: Hospital beds by type of care, 2018
Source: Eurostat (hlth_rs_bds)

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

An analysis of the number of hospital beds in relation to population reveals that there were, on average, 538 per 100 000 inhabitants in 2018 across the whole of the EU-27. Among the EU Member States, Germany recorded not only the highest number of hospital beds (661 000; 2017 data), but also the highest number relative to population size, with 800 hospital beds per 100 000 population (see Table 1); Bulgaria, Austria and Hungary also recorded more than 700 hospital beds per 100 000 inhabitants, with the ratio in Romania just below this level. Ireland (other than psychiatric care beds, excludes beds in the private health sector), Spain, Denmark and Sweden recorded the lowest numbers of hospital beds relative to their population size in 2018, all under 300 per 100 000 inhabitants.

The share of curative care beds among all hospital beds was highest in Cyprus (100 %), while curative care beds accounted for more than 90 % of all hospital beds in Denmark, Portugal, Ireland (excluding beds in the private health sector; curative care beds exclude psychiatric care beds), Slovenia and Sweden; note that in Slovenia and Sweden the number of 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 51.5 %).

In most EU Member States (no data for Portugal or Sweden), long-term care beds accounted for less than 15 % of the total number of hospital beds in 2018, with only Hungary (17.4 %), Croatia (17.4 %), Finland (19.0 %), Estonia (19.5 %) and Czechia (29.6 %) reporting higher shares.

Decreasing availability of hospital beds in most EU Member States

Between 2013 and 2018, the number of hospital beds in the EU-27 decreased by 2.5 %. Across the vast majority of EU Member States, the total number of hospital beds also declined, sometimes at a rapid pace. The largest contractions in the number of hospital beds were recorded in Sweden, the Netherlands (note that there is a break in series), Lithuania and Denmark (note that there is a break in series), where bed numbers fell by 13-18 % and in Finland where the reduction in bed numbers was 24.8 %. There were five Member States where the number of hospital beds rose between 2013 and 2018: in three of these — Spain, Romania and Malta — the gains were relatively modest (no greater than 2.7 %), whereas larger increases were recorded for Bulgaria (up 7.4 %) and Ireland (up 22.3 %; note that there is a break in series).

Figures 1 to 3 provide an analysis of the change between 2013 and 2018 in the availability (relative to the size of population) for three specific 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.

A total of 7 out of 27 EU Member States recorded an increase in their number of curative care beds in hospitals (relative to the size of their population) between 2013 and 2018 (see Figure 1 for information about the coverage for individual Member States). There were relatively small increases in the Netherlands (note that there is a break in series), Spain and Greece (note that there is a break in series). Bed numbers per 100 000 inhabitants rose at a faster pace in Romania, Ireland (note that there is a break in series; excluding psychiatric care beds and beds in the private health sector) and Bulgaria, with increases of 33, 41 and 52 beds per 100 000 inhabitants respectively. The largest increase was in Malta where there were 65 more beds per 100 000 inhabitants in 2018 than there had been in 2013, although there is a break in series. During the period under consideration, Luxembourg, Austria, Denmark (note that there is a break in series) and Lithuania saw their respective number of curative beds diminish by more than 50 beds per 100 000 inhabitants.

Figure 1: Curative care beds in hospitals, 2013 and 2018
(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. During the period 2013-2018, the number of rehabilitative beds relative to population size increased in a majority (17) of the 27 EU Member States (see Figure 2 for details of the data coverage); note that there were no rehabilitative care beds in Cyprus. The number of rehabilitative care beds increased by more than 10 beds per 100 000 inhabitants in Poland and Bulgaria (where the highest increase was recorded, an additional 23 beds per 100 000 inhabitants). By contrast, the number of rehabilitative care beds relative to population size decreased in nine Member States between 2013 and 2018. Reductions were generally no greater than 4 beds per 100 000 inhabitants, although a higher number of bed losses was reported for Germany (down 8 beds per 100 000 inhabitants between 2013 and 2017), Luxembourg and Malta (both down 14 beds per 100 000 inhabitants).

Figure 2: Rehabilitative care beds in hospitals, 2013 and 2018
(per 100 000 inhabitants)
Source: Eurostat (hlth_rs_bds)

Among the 25 EU Member States for which information is available (no information for Portugal or Sweden), there was a mixed development to the number of long-term care beds per 100 000 inhabitants during the period 2013 to 2018. Aside from the three Member States that did not report any long-term care beds in hospitals — Germany, Cyprus and Luxembourg — there were 12 where there was a decrease in their number of long-term care beds relative to population size and 10 where there was an increase. The largest fall in the number of long-term care beds per 100 000 inhabitants was recorded in Finland, dropping from 165 to 69 beds per 100 000 inhabitants between 2013 and 2018. The next largest reduction was recorded in Romania, a decrease of 12 long-term care beds per 100 000 inhabitants. By contrast, there were double-digit increases in long-term care bed numbers in Croatia and Bulgaria (both 12 additional beds per 100 000 inhabitants), as well as in Malta where the number of long-term care beds in hospitals rose from 2 to 26 beds per 100 000 inhabitants (note that there is a break in series).

Figure 3: Long-term care beds in hospitals, 2013 and 2018
(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, 2013 and 2018
Source: Eurostat (hlth_rs_bds2)

In 2018, at least 90 % of hospital beds in Lithuania, Slovenia, Croatia, Malta, Finland, Romania, 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 of the hospital beds in Germany (59 %; 2017 data) and Belgium (74 %) were in privately-owned hospitals. Aside from these three Member States, the lowest shares of beds in publicly-owned hospitals were found in Cyprus (54 %) and France (62 %).

In absolute terms, the largest number of hospital beds in for-profit private hospitals was in Germany where there were 201 000 beds in 2017, more than double the next highest number, 96 000 in 2018 in France. There were an additional 191 000 hospital beds in Germany in not-for-profit private hospitals (2017 data), which was also the highest number recorded among the EU Member States, followed in 2018 by France (56 300) and the special case of the Netherlands, where the entire stock of hospital beds (54 500 beds) was in the not-for-profit private sector.

Across the 19 EU Member States for which data are available for both 2013 and 2018 (see Table 2 for coverage), the development of the number of hospital beds in for-profit private hospitals was mixed. There was an expansion in the number of beds in eight Member States, most notably in Romania and Bulgaria where the number of hospital beds in for-profit private hospitals increased by 52 % and 49 % respectively. There was also relatively fast growth in the number of beds in such hospitals in Portugal (up 16 %). In absolute terms, the largest increases in bed numbers were also recorded in Bulgaria and Romania, where for-profit private hospitals added respectively 4 100 and 2 700 beds between 2013 and 2018, while Germany added 2 200 beds between 2013 and 2017.

Highest curative care beds occupancy rates in Ireland

Among the EU Member States, the occupancy rate of curative care beds in 2018 was often situated within the range of 61 % to 82 % (see Figure 4 for data availability). A higher rate was recorded in Ireland (90.7 %; excluding psychiatric care beds and beds in the private health sector). The lowest occupancy rates were recorded in Slovakia (66.9 %), Hungary (65.0 %), the Netherlands (64.3 %) and Cyprus (60.6 %; definition differs).

There was a relatively clear pattern among the EU Member States with respect to the change in occupancy rates of curative cure beds between 2013 and 2018. Among the 20 Member States for which data are available (see Figure 4 for data availability), 14 recorded an increase, while there were six that saw their rates decline. In percentage point terms, the largest increase in occupancy rates was recorded in the Netherlands (an increase of 19.8 percentage points between 2012 and 2018), while the largest decreases between 2013 and 2018 were in Hungary (down 5.4 percentage points) and Cyprus (down 13.7 percentage points; note that there is a break in series and that the definition differs).

Figure 4: Curative care bed occupancy rate in hospitals, 2013 and 2018
(%)
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 2018, there were approximately 3.4 million long-term care beds in nursing and residential care facilities in the 25 EU Member States where data was available (no data available for Cyprus and Portugal; 2017 data for Germany). Relative to population size, the highest numbers of long-term care beds in such facilities in 2018 were recorded in Sweden and the Netherlands, each with approximately 1 400 beds per 100 000 inhabitants (see Figure 5), while Belgium, Finland, Luxembourg, Malta, Germany (2017 data) and Slovenia also recorded 1 000 long-term care beds or more 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 to 1 000 per 100 000 inhabitants. There were six Member States that reported fewer than 400 such beds, with Greece (40 beds per 100 000 inhabitants; definition differs) and Bulgaria (30 beds per 100 000 inhabitants) recording by far the lowest ratios.

Figure 5: Long-term care beds in nursing and residential care facilities, 2013 and 2018
(per 100 000 inhabitants)
Source: Eurostat (hlth_rs_bdsns)

A comparison between 2013 and 2018 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 (no data for Cyprus and Portugal). Relative to population size, the number of long-term care beds in nursing and residential care facilities fell in Bulgaria, Luxembourg (2014-2018), the Netherlands, Latvia and Denmark (note that there is a break in series for most of these Member States). The largest falls were in Latvia and Denmark, where the number of beds per 100 000 inhabitants in 2018 was more than 100 fewer than it had been in 2013. Among the 20 Member States which reported an increase between 2013 and 2018 in their number of long-term care beds in nursing and residential care facilities relative to population, there were increases of more than 100 beds per 100 000 inhabitants in Lithuania, Slovakia and Malta.

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:

Symbols

Note on tables:

  • a colon ‘:’ is used to show where data are not available;
  • a dash ‘–‘ is used to show where data are not applicable/relevant.

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 (t_hlth_care)
Health care (hlth_care)
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)