Hospital Reform

Joint cross-state and cross-provider report on future hospital care in Westallgäu

In Westallgäu, the three hospitals Rotkreuzklinik Lindenberg, Asklepios Klinik Lindau, and Oberschwabenklinik Wangen have joined forces in the wake of hospital reforms to develop a sustainable strategy for regional, cross-state hospital care. 2perspectives supported the project, which resulted in a comprehensive structural assessment with clear recommendations for action.

Background: Why the expert opinion was commissioned

The project was initiated because the three hospital locations in Lindenberg, Lindau, and Wangen were facing increasingly changing conditions and growing challenges. In addition to general developments such as increasing medical requirements, a shortage of skilled workers, and demographic change, the situation is particularly strained by low capacity utilization, duplication of services, and a cumulative operating deficit of EUR 13.9 million at the three locations in 2023. High maintenance costs and the prospect of investment requirements are further exacerbating the economic situation. The hospital reform (KHVVG) further increases this pressure for change and makes it clear that existing structures must be fundamentally reviewed and adapted to current and future care needs.

The report aims to create a reliable basis for decisions to make hospital care in Westallgäu sustainable and economically viable in the long term.

Cooperation instead of competition

Despite being direct competitors, the three hospital locations have agreed to work closely together. All three facilities essentially compete for the same patient clientele, which can be explained by their geographical proximity and the overlap in their range of medical services. Added to this was the particular complexity of the project setting, as different stakeholders from two federal states (Bavaria and Baden-Württemberg) and from different funding structures (public, non-profit, private) were involved. This initial situation led to a high need for coordination and required a high degree of trust and willingness to compromise. During the course of the project, the situation was further exacerbated by the insolvency of the Red Cross Clinic in Lindenberg, which once again significantly increased the need for action.

Developing the right strategy for medical quality and economics in the region using an integrated approach

The project was implemented using an integrated approach that combines analysis, planning, and decision-making as a coherent process and takes various perspectives into account. The starting point was a comprehensive analysis of the structures, services, and key figures of all locations. The consideration of different location scenarios enabled the evaluation of various options for future healthcare provision, including a single-location scenario that considered an ideal location based on key criteria such as accessibility and transport links. The result was a sustainable structural concept that integrates data-based factors such as demographics, outpatient care development, and disease incidence, as well as the medical expertise and regional experience of those involved. At the same time, the effects of possible measures were evaluated and prioritized to ensure that future care is not only economically viable but also needs-oriented and patient-friendly.

Results

The results illustrate how sustainable hospital care can be organized in Westallgäu and what potential this offers for the region.

Healthcare and medical infrastructure

The report recommends concentrating inpatient care at one location to ensure efficient and comprehensive care. The focus is on basic and standard care, as well as orthopedics, spinal surgery, geriatrics, geriatric traumatology, and obstetrics. Emergency care and outpatient services are being expanded in a targeted manner to make care flexible and patient oriented.

Capacity and infrastructure

The new location will have 258 to 288 beds and around seven operating rooms, enabling approximately 14,500 to 15,700 patients to be treated as inpatients each year. Consolidating the infrastructure will enable more efficient use of staff, materials, and premises and reduce the previous duplication of resources. Travel times for staff and patients were taken into account when selecting the location.

Economic effects and efficiency gains

The consolidation of the previous locations offers several economic advantages:

1. Compensating for deficits: Consolidating the existing locations compensates for economic deficits and ensures sustainable operations despite necessary investments.
2. Targeted investments: Necessary repairs and investments at the existing locations are bundled into the new location, creating a sustainable infrastructure.
3. Reduction of duplication: Infrastructure, personnel, and resources are efficiently pooled, significantly reducing additional costs.
4. Reduction of costs for external personnel: More efficient use of internal resources reduces the need for external personnel.

Regional and strategic impact

The concept lays a solid foundation for the long-term care of the population. It considers demographic effects, as well as developments in clinical pictures and incidences and increasing demands for specialized care. At the same time, a sustainable, economically viable hospital is being created that will strengthen the long-term security of care in Westallgäu and can serve as a model for comprehensive hospital planning.