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Health care systems in transition: Germany

Busse R, Riesberg A
Copenhagen: WHO Regional Office for Europe on behalf of the European Observatory on Health Systems and Policies



The Federal Republic of Germany is situated in central Europe and covers an area of about 357 000 km2. The longest distance from north to south is 876 km, from west to east 640 km. The country shares borders with (clockwise from the north) Denmark, Poland, the Czech Republic, Austria, Switzerland, France, Luxembourg, Belgium and the Netherlands (Fig. 1). Germany has 82.5 million inhabitants, with 42.2 million women and 40.3 million men.
The area of the former German Democratic Republic (GDR) in the eastern part of Germany accounts for 108 000 km2 (30%) of the total land. Its 13.5 million residents represent 16% of the country’s total population (2003 figures, excluding the eastern part of Berlin with about 1 million inhabitants). The population density is unevenly distributed and varies between 75 inhabitants per km2 in Mecklenburg Western-Pomerania and 3804 inhabitants per km2 in Berlin. Of the 19 cities with more than 300 000 inhabitants only three (including Berlin) are in the eastern part of Germany. The largest city is the capital Berlin, with 3.4 million inhabitants. Other densely populated areas are the Rhine-Ruhr region with about 11 million people and the Rhine-Main area surrounding Frankfurt.

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