Investments in prevention are necessary.

In November last year, the European Commission and the OECD (Organisation for Economic Co-operation and Development) published their study: Health at a Glance Europe 2024. The authors looked at demographic challenges in addition to preparing a comparative overview of the latest data about health status, risk factors and the performance of healthcare systems in Europe. They have called for coordinated measures to strengthen the resilience of healthcare systems, promote prevention and secure investment in their future viability.

Shortage of skilled labour in the healthcare sector

The study showed that there was a shortage of around 1.2 million doctors, nurses and midwives in Europe in 2022. The main causes are an ageing population, which increases the demand for healthcare services, and an ageing workforce, which increases the need for retiring professionals to be replaced. Over a third of doctors and a quarter of nursing staff in the EU are over 55 years old, and they will be retiring from their working lives sometime in the future. Many countries, including Germany, rely on healthcare staff trained abroad to be able to cope with staff shortages. The influx increased significantly in 2022 compared to 2019 even though this only alleviates the shortage in the short-term. For doctors, it was 17 per cent, for nurses it was as high as 72 per cent. However, this strategy exacerbates the bottlenecks in their countries of origin, often low-income countries and even ones within the EU.

The authors of the study have recommended improving working conditions and salaries in the short-term, expanding the training of new specialist staff in the medium-term and increasing productivity and optimising patient care in the long-term through the use of highly qualified nursing staff and digital technologies such as AI.

Promoting healthy ageing

Demographic change is leading to a double challenge in the healthcare sector: The number of chronic illnesses is rising as a result of the ageing population, in addition to an increasing shortage of staff due to an ageing workforce. More than half of life expectancy from the age of 65 - which is now over 20 years - is affected by illness and disability. This is particularly true for women, who live longer but often have more health problems. The most common health problems in old age include arthritis, cardiovascular disease, dementia, diabetes, falls and mental illness. Alzheimer's and other dementias pose the greatest challenges. According to estimates, almost 8 million people in the EU had Alzheimer's or another form of dementia in 2021. A lack of physical activity and rising obesity rates are also major risk factors. Only 22 per cent of over-65s get enough exercise.

The authors' recommendations: Effective preventive measures such as promoting physical activities and vaccination programmes can reduce the burden of disease and healthcare costs in the long-term. "The costs of inaction - both in terms of reduced healthy life years and economic burden - are too high to bear," said the authors.

Health situation in Germany

The country report for Germany shows that life expectancy in Germany has only increased by less than the EU average since 2000. More than two in five Germans aged 65 and over suffer from more than one chronic illness. The main causes are risk factors such as heavy alcohol consumption, obesity and smoking, which are above the EU average. People with a low level of education are particularly affected.

The shortage of specialist staff is also a major challenge: There is still a shortage of nursing staff in hospitals despite a comparatively high number of doctors, nurses and hospital beds. To counteract this, the remuneration system has already been adjusted and initiatives launched to promote the training of nursing staff and to make the profession more attractive.

Finally, some good news: Spending on prevention in Germany has doubled during the last ten years, and it now accounts for 6.4 per cent of healthcare expenditure - slightly more than the EU average of 6.0 per cent. Germany also remains the leader in healthcare spending within the EU. The study showed how crucial targeted investment in prevention is for the health of the population by ensuring the best possible use of these resources.