Jordan Ellis
Hospitals are a vital cornerstone of every modern health system, and Europe is no exception. While each European country has its own healthcare system, most nations offer universal healthcare. Despite increased health spending, the total number of hospitals in Europe has decreased over the past few decades, with a forecast of a further decline of 91 hospitals between 2024 and 2029. In 2018, there were 2.4 million hospital beds available across the EU-27, with Germany having the highest number of beds in for-profit private hospitals in 2017. European hospitals are also major employers, with Germany, the United Kingdom, France, and Turkey each employing over a million people in 2021.
| Characteristics | Values |
|---|---|
| Number of hospitals in Europe | 24,147 (estimated for 2029) |
| Number of hospital beds in Europe | 2.4 million (in 2018) |
| Hospital bed density | Varies across countries. Bulgaria, Germany, and Romania had over 700 beds per 100,000 people in 2021, while Sweden and Liechtenstein had less than 250 beds per 100,000 people. |
| Hospital care expenditure as a share of GDP in Europe | Not specified, but healthcare spending represented almost 10% of Europe's GDP in 2024. |
| Hospitals as employers | Hospitals in the UK, Germany, France, and Turkey employed over a million people in 2021. Germany ranked the highest in the number of physicians and nurses/midwives employed in hospitals. |
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What You'll Learn
Hospital bed density varies across Europe
The number of hospital beds per capita is an important indicator of a country's healthcare system. Hospital bed density varies significantly across Europe, with several factors influencing this variation. Firstly, the definition of what constitutes a hospital bed differs across countries, impacting the calculation of bed density. For instance, some countries include only hospitals with capacities for complete or partial hospitalisation, while others may have different criteria for an institution to be classified as a hospital.
The availability of hospital beds is also influenced by a country's healthcare system. Most European nations have some form of universal healthcare, which can be categorised as single-payer, socialised, or privatised but regulated. The distribution of healthcare expenditure varies across these systems, impacting the number of hospitals and beds available. For example, countries with a single-payer system may centralise funding for hospitals, potentially resulting in a more uniform distribution of beds across regions.
The demand for hospital beds can be influenced by demographic factors such as the ageing population in some European countries, which leads to an increased need for critical care beds (CCB) or intensive care unit beds (ICU). However, the availability of CCB is poorly documented, and countries like the UK have faced challenges in meeting the demand for these specialised beds during crises.
In 2021, Bulgaria, Germany, and Romania had over 700 hospital beds per 100,000 people, while Sweden and Liechtenstein had less than 250 beds available per 100,000 inhabitants. These differences in bed density can result from varying healthcare priorities, funding allocations, and historical developments in each country's healthcare system.
While the number of hospitals in Europe has generally decreased over the past few decades, the availability and distribution of hospital beds remain essential factors in ensuring access to quality healthcare for European citizens.
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Healthcare spending in Europe
The number of hospitals in Europe was forecast to decrease by a total of 91 hospitals between 2024 and 2029. By the end of this period, the number of hospitals is estimated to reach 24,147, which will be a new minimum. The rules for registering an institution as a hospital vary across countries, which may account for some of these differences.
A report by the World Health Organization (WHO) analyzed health spending in 53 countries in the WHO European Region from 2000 to 2018. This report also reviewed key patterns and trends in health spending over time and across countries, including the priority given to health in government budgets and the adverse effects of out-of-pocket payments. The COVID-19 pandemic has also had implications for health spending, and public policy has played a role in mitigating the negative effects.
When comparing healthcare spending across Europe, there are significant differences between countries. For example, the UK's average total spending in the decade before the pandemic was £187 billion per year. If the UK had matched the average spending per person of other European countries, its total spending would have been significantly higher. For instance, matching spending per head with France or Germany would have resulted in an additional £40 billion and £73 billion, respectively, of total health spending each year. These differences in spending can have knock-on effects on access and quality of care, as seen during the pandemic when the UK's NHS struggled with capacity issues.
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Hospitals in Europe are major employers
Hospitals in Europe are some of the biggest employers, providing millions of jobs. In 2021, hospitals in the United Kingdom, Germany, France, and Turkey each employed over a million people. Germany ranked the highest in terms of the number of physicians employed in hospitals. It also employed the greatest number of nurses and midwives.
The total number of hospitals in Europe has decreased over the past few decades. Despite this, hospitals in Europe generally provide high standards of care and some are among the top-ranking hospitals in the world. Healthcare spending represented just under 10% of Europe's GDP in 2024, with around a third of that related to hospital expenditure.
In 2018, there were 2.4 million hospital beds available for use across the EU-27. The largest number of hospital beds in for-profit private hospitals was in Germany, with 201,000 beds in 2017, more than double the next highest number, 96,000 in 2018 in France. Germany also had an additional 191,000 hospital beds in not-for-profit private hospitals in 2017.
The availability of hospital beds varies greatly from one European country to another. In 2021, Bulgaria, Germany, and Romania each had over 700 beds available per 100,000 people. On the other hand, Sweden and Liechtenstein had fewer than 250 beds available per 100,000 inhabitants.
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Europe's hospital count forecast
Europe's hospital count has been on a downward trajectory over the past few decades, and this trend is forecast to continue in the coming years. Between 2024 and 2029, the number of hospitals in Europe is predicted to decrease by 91, reaching a new low of 24,147 hospitals. This forecast highlights the twelfth consecutive year of decline in the number of hospitals across the continent.
When considering Eastern Europe specifically, the decline is even more pronounced. During the same period, a drop of 151 hospitals is expected, resulting in a new minimum of 9,022 hospitals in 2029. This marks the eleventh consecutive year of decreasing hospital numbers in the region.
The reasons behind these trends are multifaceted and likely vary across countries. It's worth noting that the criteria for an institution to be classified as a hospital differ across Europe. Factors such as healthcare reforms, population changes, and the reorganisation of healthcare systems may all play a role in the declining number of hospitals.
In contrast to the decreasing number of hospitals, Europe's healthcare spending has been on the rise, with hospital expenditure accounting for a significant portion of it. Despite this increase in spending, the number of hospital beds available is also projected to shrink. Between 2024 and 2029, Europe is expected to lose 64,700 hospital beds, resulting in a new minimum of 4.5 million beds in 2029.
While the number of hospitals may be decreasing, Europe's hospitals remain some of the top-ranking healthcare providers globally, offering high standards of care. The continent's healthcare landscape is diverse, with various systems in place, including single-payer, socialized, and privatized but regulated models.
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Quality of healthcare in Europe
Europe has some of the best hospitals in the world, and the continent's healthcare systems are generally of a high standard. While each European country has its own healthcare system, most nations have some type of universal healthcare. They can be roughly categorized into three systems: single-payer, socialized, and privatized but regulated.
The quality of healthcare in Europe varies from country to country and is determined by various factors, including healthcare spending, the number of healthcare professionals, and the availability of hospital beds. In 2020, healthcare spending in the EU was 10.9% of GDP, an increase of one percentage point from 2019. While healthcare spending has continued to increase, the total number of hospitals in Europe has decreased over the past few decades, along with the number of hospital beds. Hospital bed density varies significantly between European countries. For example, in 2021, Bulgaria, Germany, and Romania had over 700 beds available per 100,000 people, while Sweden and Liechtenstein had fewer than 250 beds per 100,000 inhabitants.
The COVID-19 pandemic highlighted the importance of robust and resilient public health systems in Europe. The response to the pandemic varied across European countries, with some countries, such as Sweden and Greece, experiencing a collapse of their healthcare systems and higher mortality rates. However, a widespread vaccination campaign helped lower the COVID-19 mortality rate in Europe.
Despite the variations in healthcare quality across Europe, European countries dominate the list of nations with well-developed public health systems. Norway, Iceland, and Sweden ranked as the top three European countries in the health index score in 2023, which evaluates indicators such as health outcomes, health systems, sickness and risk factors, and mortality rates.
Overall, while there may be disparities in healthcare quality within Europe, the continent is known for its high-quality healthcare systems and hospitals, which are among the top-ranking globally.
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Frequently asked questions
As of 2024, there were a total of 24,147 hospitals in Europe.
Yes, the total number of hospitals in Europe has decreased over the past few decades.
Most European nations have some type of universal healthcare. They can be categorized into three systems: single-payer, socialized, and privatized but regulated.
The number of hospital beds varies across Europe. In 2021, Bulgaria, Germany, and Romania had over 700 beds available per 100,000 people, while Sweden and Liechtenstein had less than 250 beds.
