Download PDF
CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2024; 84(10): 920-927
DOI: 10.1055/a-2376-9748
GebFra Science
Statement

Structural Requirements for the Outpatient Treatment of Benign Diseases of the Uterus

Article in several languages: English | deutsch
Cosima Brucker
1   Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinik der Paracelsus Medizinischen Privatuniversität, Klinikum Nürnberg, Nürnberg, Germany
,
Thomas Dimpfl
2   Frauenheilkunde und Geburtshilfe, Klinikum Kassel, Gesundheit Nordhessen, Kassel, Germany
,
Anton Scharl
3   Onkologische Fachklinik Bad Trissl, Oberaudorf, Germany
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

In many cases, outpatient surgical treatment of benign diseases of the uterus has advantages over inpatient care. This has been demonstrated by the healthcare situation in other countries. However, the prerequisite for the provision of outpatient services is that this does not lead to any impairment in the quality of care or of patient safety. The ultimate goal should not be to reduce costs but rather to maintain and, ideally, improve the quality of care. This requires that services are not just defined by the surgical procedure but also by the entire treatment chain, including, for example, psychosocial support, and are remunerated accordingly. It is particularly worrying that the final decision as to whether an outpatient operation is possible is not the responsibility of the operating unit, but of the “Medizinischer Dienst,” with the corresponding options and threats of sanctions. This situation is unique internationally and requires a paradigm shift. Furthermore, structural prerequisites must be maintained which currently only exist inadequately in Germany. Since a substantial proportion of planned outpatient operations require immediate or secondary inpatient treatment, there must be a barrier-free transition between the outpatient and inpatient sectors. This will require the creation of networks between outpatient service providers and one or more hospitals that are equipped and competent to manage even complex complications. It is important to create structures that, with intensive involvement of the operating unit, include adequate preoperative evaluation and patient education as well as needs-oriented postoperative care at home. The current separation of sectors is a significant hinderance. Moreover, when expanding and promoting outpatient surgery, the aspect of training and further education of specialist staff must be taken into account, as well as cross-sectoral quality assurance.

Based on a review of the international literature, this article presents 13 recommendations for adequate structures when providing outpatient services which should serve as a prerequisite for the greatest possible guarantee of patient safety.

Keywords

outpatient surgery - patient safety - networks - structures - specialist training - reimbursement


Publication History

Article published online:
01 October 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany