According to the Bertelsmann Stiftung, superfluous examinations, operations, therapies and drug prescriptions that would be "questionable in their usefulness" would harm patients and be associated with burdens and dangers.

For example, around 70,000 thyroid surgeries were performed in Germany every year although there were no malignant changes to the thyroid in around 90 percent of cases. "Many of these operations could be avoided with better diagnostics".

According to the study, unnecessary therapies and operations would waste valuable resources in the German health system, which would then be missing for "actually necessary treatments."

Planning, remuneration and tax deficits in the German health system were the drivers of the problem. But the expectations and attitudes of patients and doctors would also play a major role, according to the Bertelsmann Stiftung.

The greater a patient's fear of a certain disease, the greater was their desire for additional examinations or preventive measures, said the study. And those fearful patients were less aware of the necessity and efficiency of the treatment.

If doctors offered a certain measure that would be widespread and known to patients, its perceived importance also increased. As a result, the probability that patients in Germany would question the appropriateness of the recommended medical therapy decreased.

With 11.2 percent of Germany's gross domestic product spent on healthcare, no other country in the European Union would spend as much on health as Germany, the study noted.

Per capita health expenditure in Germany amounted to almost 4,000 euros (4,400 U.S. dollars) per year, which put Germany 43 percent above the EU average. In terms of average life expectancy, however, Germany only ranked 18th in the European Union.

The Bertelsmann Stiftung emphasized that doctors had to assume ethical responsibility and refrain from unnecessary services. Also, the benefits and risks of medical services would need to be made clearer for patients. To achieve this, politics would also be called upon.