German Urgent and Emergency Care System

Germany has no strict gatekeeping system for urgent and emergency care, allowing patients to directly access multiple entry points without prior triage or centralised guidance. The 116117 hotline provides telephone triage and referral to out-of-hours services or emergency departments but does not dispatch ambulances. Fragmentation across sectors limits coordination, patient safety, quality monitoring and strategic planning. EMS operations in Germany increase by approximately 4% annually. Ambulatory care-sensitive conditions continue to rise despite available ambulatory care, particularly back pain and soft tissue disorders.