Emergency rooms overloaded: when to call 116117

Germany's emergency rooms are treating more people who could have been helped elsewhere, while fewer hospitals share the pressure. That is the main finding of the Barmer Krankenhausreport 2026 (hospital report), presented by the statutory health insurer in Berlin on 27 October. Barmer now wants every patient who is not in a life-threatening situation to get an assessment by phone before going to hospital, a step the new federal emergency care reform leaves voluntary. For people living in Germany, the system has two numbers: 112 for emergencies and 116117 for urgent problems outside practice hours.

What the Barmer report found in emergency rooms

According to the report, hospitals in Germany carried out about 12.3 million outpatient emergency treatments in 2015 and about 12.7 million in 2024. Outpatient means the patients were examined and then sent home rather than admitted to a ward. The overall increase is small, but the number of hospitals providing this care fell over the same decade, leaving fewer sites to share the cases. Barmer calculates that the average hospital handled 8.7 percent more outpatient emergencies in 2024 than ten years earlier.

The average conceals large differences. In one in ten hospitals the number of these cases more than doubled since 2015, ZDF reported, citing the study. In two out of five hospitals the caseload grew by 39 percent, while in another two out of five it fell by 26 percent. Barmer only counts hospitals with at least 50 outpatient emergency treatments a year, and by that measure their number dropped from 1,614 to 1,536. The figures come from billing data for about 8.5 million people insured with Barmer and were extrapolated to the whole population. WeLiveIn.de has reported before on record numbers of emergency room visits in Germany.

Why some regions use emergency rooms far more

Use varies considerably by region. According to the Barmer report, hospitals in Baden-Württemberg treated about 50 percent more outpatient emergencies per inhabitant than the national average in 2024, while hospitals in Thuringia were about 22 percent below it. The study's author, the physician Daniel Grandt, gave a lower figure in his written statement for the presentation, putting Baden-Württemberg 35 percent above the national average. The news agency dpa summed up the gap by saying people in the south-western state used hospital emergency care almost twice as often as people in Thuringia.

Grandt said the regional differences could be explained neither by demographics nor by medicine. He also noted that many cases are simple. According to Barmer, 60 percent of outpatient emergency patients were treated without any equipment-based diagnostics such as ultrasound, X-ray or CT scans. Grandt added that on weekdays six in ten of these visits took place between 8 am and 6 pm, when a family doctor would usually have been open.

Grandt stressed that patients with worries that turn out to be unfounded should not be blamed. Many people simply cannot judge how urgent their symptoms are, he said, and in a recent survey more than half of the patients questioned in emergency departments did not know that a GP out-of-hours service existed. He called for a nationwide information campaign, which he described as a missing piece of the reform.

Barmer wants mandatory triage before emergency rooms

Barmer chief executive Christoph Straub warned that crowded waiting areas put everyone at risk, including patients who really do have an acute emergency. "Not every supposed emergency is actually one," he said at the presentation, according to dpa. In ZDF's breakfast programme Morgenmagazin he added that people with serious illnesses and severe pain end up waiting longer.

He proposes a compulsory first assessment by phone, later supported by digital tools, for everyone who is not in a life-threatening situation. Patients would then be directed to the right level of care, such as a GP practice, an out-of-hours practice or the hospital, and would get a fixed appointment there. Barmer points to Denmark, where people have to call first except in life-threatening cases. According to Grandt, 42 percent of the Danish phone assessments close the case completely, with no need for a hospital or practice visit.

Straub also wants more home visits by doctors and broader responsibilities for nurses and other non-medical staff in care homes. The aim is that frail older people are not taken to hospital for problems that could be treated where they live.

What the new Notfallreform changes

The Bundestag passed the Notfallreform (emergency care reform) on 15 October, with votes from the governing coalition and the Greens, while the AfD and the Left Party abstained, dpa reported. According to the Federal Health Ministry, the 116117 number will be split into an appointment service and an Akutleitstelle, an acute care control centre that works around the clock, gives advice by phone or video and can send a doctor for a home visit where needed. Hospitals are to run Integrierte Notfallzentren (integrated emergency centres), which combine the emergency department, an out-of-hours practice and a central assessment desk. The 116117 centres and the 112 rescue control centres are also to be connected digitally so that information is passed on without patients having to repeat everything.

Federal Health Minister Carsten Linnemann called the reform long overdue. The insurer's criticism is narrower: the law offers the phone assessment but does not oblige anyone to use it, so patients can still walk straight into a hospital emergency department. "Without a clear requirement, the success of the reform is questionable," Straub said, as quoted by dpa and ZDF.

116117 or 112: how expats should use emergency rooms

The two numbers serve different purposes, and calls to both are free from landlines and mobile phones. 112 is the emergency number for life-threatening situations, such as chest pain, signs of a stroke, heavy bleeding, serious breathing problems or a bad accident. It reaches the rescue service, which sends an ambulance and decides which hospital is suitable.

116117 is the ärztlicher Bereitschaftsdienst, the on-call medical service run by the doctors who treat statutory health insurance patients. According to its official website, it is meant for complaints that would normally take you to a practice but cannot wait until the next day. The line is staffed 24 hours a day, seven days a week, and works nationwide without an area code. The service can send you to a Bereitschaftspraxis, an out-of-hours practice that opens in the evenings, at weekends and on public holidays. Dental problems are not covered, as there are separate dental emergency services.

The website 116117.de also has a symptom checker called Patienten-Navi, a search function for nearby out-of-hours practices and an appointment service for people with statutory insurance. Parts of it are available in English, Arabic, Turkish, Ukrainian and several other languages. During normal opening hours, your own family doctor, the Hausarzt, remains the first place to go, although a shortage of family doctors is expected in the coming years. Always take your health insurance card to a practice or hospital.

When in doubt, call 116117 and describe your symptoms, and call 112 immediately if anything could be life-threatening. Going to the emergency rooms with a minor problem usually means a long wait, and according to Grandt such visits often end with the patient being referred back to a family doctor anyway.