The media's coverage and framing of hospital reforms: The case of Germany

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Abstract Aim In Germany, a long-lasting debate about the need for a hospital reform, including centralisation, now resulted in reform plans. As cutbacks to essential services such as hospitals are an emotional topic, the public should be properly informed, which is a central role of the media. Based on a media analysis of a large-scale hospital reform in Denmark, showing that the media’s reporting might have had an agenda-setting effect, we analysed the media’s coverage and framing of restructuring the hospital landscape in German newspapers. Subject and methods A systematic search identified relevant articles in national and regional newspapers. The coverage between January 2018 and January 2023 was analysed regarding quantity and main theme (agenda-setting). Each article’s title and main text were analysed for tone and whether it focused on episodic (single events) or thematic (broader context) framing. Results A total of 705 newspaper articles (592 regional, 113 national) were included. Both regional and national newspapers mainly used episodic framing. Regional newspapers mostly reported on single closures of hospitals or departments. The tone of the title and main text in national newspapers was mainly negatively depicted, which applied to less than half of the articles in regional newspapers. These differences were, however, not statistically significant. Conclusion Results indicate higher agenda-setting effects in regional compared to national newspapers. However, the overall high amount of episodic framing can result in less attribution of responsibility to policy-makers, thereby conserving the status quo. To succeed, a media strategy might help to raise problem awareness among the public.