Health map 2023

The health map is a report that provides a detailed overview of the hospital sector, including an inventory covering structural resources and their organisation, and a statement of activities and utilisation rates for these structures.

The aim of the health map is to provide objective data for hospital planning, to meet the objective of transparency in healthcare provision, to provide information on trends and comparisons, and to meet international reporting obligations (WHO, Eurostat, OECD).

This edition of the health map presents the structural hospital inventory in 2023, as well as changes between 2012 and 2021 in various indicators relating to hospital admissions and hospital medico-technical activities.

Martine Deprez, Minister of Health and Social Security, points out: 'The 2023 health map demonstrates our commitment to efficient and transparent management of the hospital sector, as well as our desire to strengthen Luxembourg's hospitals in their role of providing specialised and multidisciplinary care, in accordance with the coalition agreement. These objective data enable us to anticipate the needs of the population, strengthen our capacities and ensure quality care for all, within a solid and resilient healthcare system.'

Dr Françoise Berthet, President of the National Health Observatory, adds: 'In recent years, the demographic growth of the resident population and the increase in the use of hospital care by non-resident insured persons have put increasing pressure on the hospital sector. This pressure has been eased by the increasing use of day hospitalisation.

Structures and equipment in 2023, and their evolution since 2021

In 2023, Luxembourg had 10 hospitals, including 4 hospital centres spread over 11 sites (+1 site) and 6 specialist hospital establishments, as well as an establishment for people at the end of their lives, an establishment for spa treatments and a diagnostic centre.

In 2023, the capacity in Luxembourg amounted to 2,640 hospital beds (-27 beds), including 2,022 acute beds (-20 acute beds). This means that 95.2% of the hospital beds authorised in 2019 (2,772 beds) have been installed by 2023.

In total, the GDL had a ratio of 4.0 hospital beds per 1,000 inhabitants in 2023 (4.2 in 2021), or 3.04 for acute beds.

In terms of day hospital beds, there were 573 beds installed in 2023.

All the equipment and appliances subject to national planning under the 2018 Hospital Act had been installed by 1 July 2023. For medical imaging, there were 15 scanners (+2), 12 MRIs (+1), 8 gamma cameras (+1), 7 mammography machines and 1 PET-Scan.

New provisions of the Hospital Act and ministerial authorisations: an increase in hospital beds and equipment capacity from 1 January 2024

In accordance with the Act of 22 December 2023 amending the Hospital Act 2018 and the ministerial authorisations extending the operation of hospitals, the total number of planned and authorised beds has increased:

• Appendix 2 of the Hospital Act 2018 increases the maximum number of nationally planned beds to 3,153 from 1 January 2024. This number includes 2,346 acute beds, representing a 5.0% increase in total acute bed capacity.
• As of 1 January 2024, 2,786 hospital beds have been authorised, comprising 2,124 acute beds, 575 medium-stay beds and 87 long-term care beds. A total of 743 day hospital beds have been authorised.

As of 1 January 2024, the maximum number of PET scans that can be authorised nationally is now set at two, while the number of bone densitometers is now limited to three, compared with one previously.

Activity in hospital centres in 2021 and trends since 2012

In 2021, there were 139,352 hospital stays (51.9% inpatient and 48.1% outpatient), with an average length of stay of 7.3 days, or 593,528 hospital days, corresponding to an occupancy rate of 71.2%.

• The number of inpatient stays increased. There was strong growth in day hospitalisation, while the number of inpatient stays fell slightly.
• The shift to outpatient care continues to develop. Day hospitalisation has shown significant growth over the last 10 years (+4.9% per year between 2012 and 2021), for both medical and surgical activity. Chemotherapy and dialysis sessions have increased by an average of 2.9% and 3.1% per year respectively between 2012 and 2021, and outpatient surgical activity for tracer procedures has risen from 58.9% in 2017 to 74.7% in 2021.)
• The number of days spent in hospital has fallen slightly. Over the same period, the number of hospital stays has risen; in other words, there are more hospital admissions but they are of shorter duration.
• The average length of stay for overnight hospital stays remained stable.
• Bed occupancy: between 2017 and 2021, the annual occupancy rate for acute beds varied between 67.9% and 78.1%.

Cross-border workers are increasingly attracted to Luxembourg hospitals

In 2021, non-residents accounted for 8.8% of all hospital stays and, in 2022, 17.3% of maternity deliveries. Non-residents' use of medico-technical activities is also notable in the fields of medical imaging (including MRI and PET-Scan), in vitro fertilisation, and urgent and unscheduled care in emergency departments and policlinics.

The 2023 edition of the health map is published online in a format providing direct access to data presented in the form of downloadable tables and graphs.

The health map is drawn up and updated every two years by the National Health Observatory, in accordance with the provisions of the Act of 8 March 2018 (as amended) relating to hospital establishments. It will shortly be enriched by a supplement on paediatric hospitalisation activity, which complements the ‘Eng gesond Zukunft’ report, based on data from the Documentation and Classification of Hospital Stays (DCSH), and by a booklet presenting an initial series of indicators relating to the quality of care and the performance of the healthcare system.

Discover the full report at: https://sante.public.lu/fr/espace-obsante/carte-sanitaire/carte-sanitaire2023.html

Press release by the Ministry of Health and Social Security / National Health Observatory