Administrative burdens and safety risks in German healthcare

German healthcare providers continue to report significant administrative burdens and rising costs driven by regulatory and insurance-related requirements.

In the nursing sector, the Federal Association of Private Providers of Social Services (bpa) reports that facilities lose approximately 2.3 million hours of labor annually due to electronic health card (eGK) administration. Simultaneously, hospitals face increased personnel costs due to audits conducted by the Medical Service (MD). The German Hospital Association (DKG) reports that roughly 4,000 full-time employees are dedicated to processing these audits, costing approximately 245 million euros annually. Gerald Gaß, head of the DKG, has criticized this “culture of mistrust” and described it as a tool for cost optimization rather than quality improvement.

New findings from the Zentrum für Qualität in der Pflege (ZQP) have highlighted additional safety risks within elderly care. A study revealed that 50 percent of caregivers reported medications were administered incorrectly or not at all within a six-month period, with 19 percent of those cases involving repeated errors. Furthermore, 26 percent of respondents noted issues regarding expired or missing medications and prescriptions. These safety concerns are linked to broader patient risks, including 36 percent of care recipients experiencing falls with injuries and 51 percent requiring hospital stays within a year. The ZQP report also noted the impact on staff, with 53 percent of caregivers reporting psychological distress.

Recent data has also highlighted disparities in preventative care. Health insurer Barmer noted that only 4.2 percent of home-based care recipients utilized dental preventative services in 2024, compared to 26.9 percent of those in stationary care. Meanwhile, reforms such as the introduction of a relief budget in July 2025 aim to provide more immediate support for respite care.