Medical laboratory diagnostics in Germany - a status report 2024.

Background and aim of the work: Laboratory diagnostics (in-vitro diagnostics, IVD) is one of the main pillars of evidence-based medicine; for many medical fields - such as endocrinology - laboratory tests are conditional, but not indispensable for any discipline. The majority of diagnoses can only be reliably made if laboratory tests are taken into account. The aim of this study is to describe the provision of IVDs to the population in Germany in an overall view and to discuss development perspectives in the sense of basic healthcare research, particularly on the basis of publicly accessible data.

Methods: For this purpose, in particular the federal health reporting, reports of the German Federal Statistical Office, the medical register of the German Medical Association and data from the Associations of Statutory Health Insurance Physicians were analysed, as well as a large amount of publicly accessible information from associations and medical institutions.

Results: The provision of laboratory services in Germany is strongly interlinked between the sectors as they are offered by practicing laboratory physicians, in inpatient facilities and also directly in the practices and medical care centres of other specialist groups. There are currently around 1,200 specialists in laboratory medicine and 840 specialists in microbiology, which together equates to around 0,7% of all specialized physicians in Germany. Around 2/3 of laboratory physicians work in private practice. After the group of general practitioners, laboratory doctors are the second most frequently consulted group of doctors in Germany as representatives of a non-curative specialty. A total of around 108,000 people work in medical laboratories (1.8% of the entire healthcare workforce). The annual cost of laboratory diagnostics is around 150 euros per capita, totaling around 12.9 billion euros per year, which corresponds to around 2.6% of the total costs of the German healthcare system. Only around 17% of hospitals - predominantly maximum care facilities - have their own laboratory infrastructure, while the majority of hospitals are supplied with laboratory services by practicing laboratory doctors. In the latter, it is now predominantly quite large laboratory medicine units that provide laboratory tests nationwide on the basis of a complex logistics and data infrastructure, which is flanked by patient-related laboratory diagnostics in practices and medical care centres in a wide range of disciplines.

Conclusion: A fairly comprehensive picture of the provision of laboratory services in Germany can be obtained from publicly accessible sources. Laboratory diagnostics is an essential and efficient, system-relevant element of the German healthcare system, in which a relatively small number of medical specialists and healthcare professionals bear a great degree of responsibility for maintaining adequate care.