Krisen- und Sanierungsmanagement in deutschen Krankenhäusern. Empirisch-qualitative Untersuchung zur Bewältigung von Kranken-hauskrisen durch Entwicklung von Sanierungsempfehlungen für einen Turnaround

Hospitals are facing increasing economic pressure due to various factors such as the coronavirus pandemic, reforms, and increasing outpatient care. A "cold structural change" is expected in the hospital market until the German government's planned hospital reform, the "Krankenhausversorgungsverbesserungsgesetzes (KHVVG)", is implemented. According to the Hospital Rating Report, it is predicted that around 70% of hospitals will experience an annual loss by 2024. Already in 2022, 10% of German hospitals were at risk of insolvency, with at least one third of hospitals reporting annual losses (Augurzky et al., 2024, S. 112). To overcome these challenges, financially struggling hospitals will need comprehensive crisis and reorganization management. Without public funding support, it will be difficult for these hospitals to navigate the difficulties they face.

This research paper addresses two key issues: firstly, the emergence and causes of economic hospital crises; and secondly, the derivation of suitable reorganization options for the hospital sector. In this respect, both extra-judicial reorganisation and restructuring measures as well as the reorganisation options under the Insolvency Code are discussed. The evaluation of the academic literature to date has shown that the topic of hospital reorganisation has been insufficiently investigated. Although there are numerous scientific contributions on corporate reorganisation in industry, these cannot be easily transferred to the hospital sector due to the special features of the hospital sector.

The aim of this study is therefore to develop practicable restructuring approaches for the hospital sector on the basis of a well-founded analysis and to identify various restructuring options.

The topic of hospital reorganisation was examined in detail on the basis of two qualitative studies, a case study and expert interviews. The recommendations for action developed have the objective of establishing the topic of hospital refurbishment, both in the field of scientific investigation and in the context of clinical practice. Increased awareness should help to ensure that hospital closures are avoided wherever possible due to increasing negative annual results and the current increased risk of insolvency.