Medical Device Daily European Editor and Staff Reports

A report on healthcare expenditures from the German Federal Office of Statistics shows healthcare spending in Germany increased by nearly €8 billion in 2007, increasing 3.2% over 2006 and totaling €252.8 billion for 2007.

Healthcare spending is considered a key issue by more than two-thirds of Germans for the parliamentary elections set for September that will determine if Angela Merkel and the Christian Democratic Union stay in power.

A review of recent reports of German healthcare, translated by BVMed, the national association of medical device makers, and published in the association's May issue of MedInsight, show an acceleration of a trend toward privatization of hospitals in Germany and a dramatic shift to the outpatient setting.

Almost half of public healthcare spending for goods and services, or €124.4 billion ($165.5 billion), was for outpatient care with medical procedures accounting for over 30% at €38.4 billion ($51.2 billion), according to the German Federal Office of Statistics.

Outpatient nursing care saw the greatest increase at 6.7% totaling €7.9 billion in 2007.

Where outpatient spending grew 4.9% over 2006, spending for inpatient care crept forward by 1.7% to total €91.8 billion ($122.5 billion).

Hospital facilities accounted for 70% of the spending at €64.6 billion ($86.25 billion) and partial inpatient care facilities drew €19.4 billion ($26 billion).

According to a survey, "Hospital Trend 2009," from Steria Mummert Consulting (Berlin), 73% of specialized staff and executives working in German hospitals said they are increasing the focus on outpatient care.

As of the start of the new year, hospitals in Germany were freed up from restrictions against outpatient care and are now increasing investments in such facilities, especially for treating cancer and heart disease.

German private hospitals outperform public care

Expanding by almost 42% over the past 10 years, privately run hospitals now claim a 28% share of the German market and play a key role in providing medical services in rural areas, according to a report from RWI Essen (Rheinisch-Westf lisches Institut f r Wirtschaftsforschung; Essen, Germany) and the Institute of Health Economics (IfG; Institut f r Gesundheits konomik, Munich).

From 1996 through 2007, the report found the number of public hospitals declined by 31% while medical centers managed by non-profit institutions dropped by almost 19%.

The RWI Essen-IfG report forecasts that with continuing cost and competitive pressures on the hospital market, and with a superior economic performance by hospitals under private management, this trend will accelerate in the near term.

According to the report, the number of hospitals in under-served rural areas of Germany under private management is now greater than publicly run centers and that the quality of care is not lower than equivalent measures reported from hospitals under other management models.

The report also found private hospitals on average are more cost-effective than their public and non-profit equivalents with lower costs for personnel and materials as a percentage of annual revenue, yet on average there is more medical staff, both doctors and nurses, attending to patients in the private hospital settings.

The in-depth RWI Essen-IfG analysis also found hospitals under private management have a "a distinctly higher investment quota" with greater autonomy for capital investment and a ready access capital sources independent of German federal or state funding.

The superior financial performance of private hospitals also increases opportunities for internal financing of new or replacement equipment.

Finally, the report concludes that privately managed hospitals in Germany "not only received less state subsidy funds, but at the same time paid, for example in 2006, 150 million ($200 million) of profit tax to the state," where public and non-profit hospitals are tax-exempt.

eZono 3000 is introduced

Saying that widespread adoption of ultrasound-guided regional anesthesia has been hampered by complex technology and high training barriers, eZono AG (Jena, Germany) has unveiled at the German Anesthesiology Congress in Liepzig the eZono 3000, which it terms "a novel ultrasound imaging solution that lowers these hurdles."

The company said eZono 3000 is the first portable system designed for anesthesia applications from the ground up, with complexity "replaced by intuitive, context sensitive icon and gesture based control via a unique touch screen interface."

It said "unprecedented processing power enhances imaging – all packed into a robust notebook form factor." eZono said its onboard training system, Cue Cards, "revolutionizes the learning experience."

Cue Cards' breakthrough, the company said, is to transform anesthetists' 3-D static anatomical understanding to 2-D real time sono-anatomy using multimedia content such as 3-D models, videos and images for synchronized reference and workflow guidance.

"This helps anesthetists to train faster and increase nerve block effectiveness," eZono said. "Furthermore the system automatically loads pre-sets – most commonly used system preferences – for a chosen anaesthesia or vascular access application."

"We are proud to introduce essential new features, like our Cue Cards, but also a more affordable system. Achieved by combining leading-edge technology, close collaboration with practicing clinicians, and a lean supply-chain" said CEO Allan Dunbar.