From the Guidelines
The health workforce building block in Germany should be assessed and strengthened based on key indicators, including physician density, nursing personnel density, health worker distribution, workforce aging metrics, and training capacity, with a focus on addressing geographic maldistribution, aging workforce, and adapting to changing care models. To assess the health workforce building block in Germany, key indicators such as physician density (4.3 physicians per 1,000 population), nursing personnel density (13.9 nurses per 1,000 population), health worker distribution (showing urban concentration with rural shortages), workforce aging metrics (approximately 25% of physicians over age 60), and training capacity (approximately 10,000 medical graduates annually) should be considered 1.
Strengths and Limitations
The strengths of Germany's health workforce include:
- Robust professional education system
- High overall workforce density compared to EU averages
- Strong regulatory frameworks ensuring quality However, limitations include:
- Geographic maldistribution with rural shortages
- Aging workforce creating sustainability concerns
- Increasing workload and burnout among health professionals
- Challenges in adapting to changing care models requiring more interdisciplinary approaches
Digital Competencies
In terms of digital competencies, the public health workforce in Germany needs to develop new skills to leverage digital technologies for public health functions, including monitoring and addressing the health implications arising from digital transformation in society 1.
Recommendations
Based on the most recent and highest quality study 1, Germany's health workforce building block should prioritize addressing geographic maldistribution, aging workforce, and adapting to changing care models, while also developing digital competencies to support the digital transformation of public health. Key recommendations include:
- Increasing training capacity and retention of health professionals in rural areas
- Implementing policies to address workforce aging and burnout
- Promoting interdisciplinary approaches to care
- Developing digital competencies in public health education and training programs By addressing these challenges and developing digital competencies, Germany's health workforce can be strengthened to improve health outcomes and address the changing needs of the population.
From the Research
Assessment of the Health Workforce Building Block in Germany
The health workforce building block in Germany is a crucial component of the country's healthcare system, with a dense network of ambulatory care physicians and hospitals providing good access to care with free choice of provider and short waiting times 2. However, there are challenges in the system, including the strong separation of ambulatory and inpatient care, the coexistence of statutory health insurance (SHI) and substitutive private health insurance (PHI), and a complex stewardship framework 2, 3.
Strengths of the Health Workforce Building Block
- Universal coverage for a wide range of benefits, with 85% of the population covered by statutory health insurance and 11% by substitutive private health insurance 3
- High level of service provision, with a dense network of ambulatory care physicians and hospitals 2
- Good access to care with free choice of provider and short waiting times 2
- High per capita spending on health, with most financing coming from public funds 2
Limitations of the Health Workforce Building Block
- Strong separation of ambulatory and inpatient care, which can hinder the coordination and continuity of patient treatment 2, 3
- Coexistence of statutory health insurance (SHI) and substitutive private health insurance (PHI), which weakens the principle of solidarity 2, 3
- Complex stewardship framework, which promotes incrementalism and makes it more difficult to implement reforms 2
- Maldistribution of staff and skills, particularly in rural areas 4
- Demanding working conditions in long-term care jobs, which can be harmful to health 5
Relevant Indicators
- Density of health workers per 1,000 population
- Distribution of health workers by sector (ambulatory care, hospital care, long-term care)
- Skill mix and qualification levels of health workers
- Patient satisfaction and quality of care indicators
- Economic parameters, such as healthcare expenditure and efficiency metrics 4, 6