Credit: Ministry of Heath

The National Health Observatory of Luxembourg's Ministry of Health has recently published the "carte sanitaire" (health map) report, a report that draws up a detailed inventory of the hospital sector, with an inventory that covers the structural and human resources and their organisation, as well as a statement of the activities and rates of use of these structures in Grand Duchy.

The health map serves as the basis for estimating national health needs, both in terms of the number of hospital establishments and in terms of hospital beds and services.

The report presents the structural inventory in 2021 as well as the evolution, from 2010 to 2019, of various indicators related to hospitalisations and hospital-medical-technical activities. It also provides an overview of the organisation and activities related to COVID-19 in 2020 and 2021.

Luxembourg's Minister of Health, Paulette Lenert, underlined: “The health map feeds the preliminary reflections on hospital planning and offers us rich and useful information on which we can base our assessments and make informed decisions. It also serves us as a reference document during the various works of the Gesondheetsdësch.”

Dr Françoise Berthet, project manager for the creation of the National Health Observatory, said: “The sector is facing the challenge of significant demographic growth and a growing demand for care for non-resident insured persons.”

Structures and equipment in 2021

Luxembourg has ten hospitals, including four hospital centres and six specialised hospital establishments, as well as a reception establishment for people at the end of life, an establishment for spa treatments and a diagnostic centre. In 2021, Luxembourg reception centres had a total capacity of 2,667 hospital beds, which is equivalent to 4.2 hospital beds per 1,000 inhabitants.

Equipment and devices subject to national planning and in accordance to the hospital law of 2018, were fully equipped and installed. For medical imaging, there are thirteen scanners, eleven MRIs, seven gamma-ray cameras, seven mammographs, one PET-CT and one prone-table.

The activities of hospital centres in 2019 and their evolution since 2010

In 2019, for hospitals, there were 142,536 stays (including 55.2% in in-patient hospitalisation and 44.8% in day hospitalisation), with an average duration of 7.4 days, i.e. 645,686 days of hospitalisation corresponding to a 78.1% occupancy rate.

  • The number of hospital stays had increased. The growth in day hospitalisations is strong, while the number of inpatient stays remained stable.
  • The shift to ambulatory care has got off to a good start: compared to total hospitalisations, day hospitalisation has increased sharply. Outpatient surgical activity for tracer procedures has experienced strong growth.
  • Hospital days have barely increased. This growth is less strong than that of stays; in other words, hospitalisations are more numerous but of shorter duration.
  • The average length of stay for hospitalisations with overnight stays remained stable.
  • Bed occupancy: between 2015 and 2019, the annual occupancy rate of acute beds varied between 72.9% and 78.1%.
  • The attraction of cross-border workers for Luxembourg hospitals is constantly increasing: hospitalisations of cross-border workers represent 8% of hospital stays in 2019.

Organisation and activities related to COVID-19

In the context of the COVID-19 pandemic, the organisation of the supply of primary care has made it possible to meet consultation needs and to maintain attendance at hospital emergency services at a relatively stable level during successive pandemic waves.

The number of stays due to COVID-19 is similar in 2020 and 2021. The high proportion (17.3%) of stays involving intensive care has had a strong impact on the average length of stay. Notably, it is the age group of 50 to 59 years that represented the highest number of hospitalisations from March 2020 to the end of 2021. Men, in 21.4% of cases, stayed in intensive care and thus represent more than teo-thirds of stays with intensive care, as has been observed in other countries. The majority of hospital deaths concern older people, from the age of 70, with a minimal gender gap.

The 2021 edition of the health map is published online (www.obsante.lu/cartesanitaire) in a new format that offers 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 and will be supplemented as additional data become available.

While waiting for the Council of Observers to be formed, it is the team in charge of creating the Observatory designated by the Minister of Health, who has produced this 2021 edition of the health map.