Ambulantisierung in der Schulter- und Ellenbogenchirurgie – Chance oder Risiko?

The German healthcare system is facing various challenges, including demographic changes and a shortage of medical professionals. In response to these challenges, the Hospital Nursing Relief Act (KHPflEG) was enacted in December 2022, introducing the concept of sector-neutral remuneration to reduce unnecessary hospital stays. The catalog of outpatient surgeries (AOP) is updated and expanded annually, resulting in an increasing number of arthroscopic and open shoulder and elbow surgeries being performed on an outpatient basis. International trends show a rise in outpatient procedures, while inpatient procedures decline. Patient satisfaction and safety seem to increase in outpatient care, but there is a need for flexibility for medically necessary inpatient treatments. Hospitals must address infrastructural challenges, and the surgical training of young physicians is jeopardized by the shift of arthroscopic surgeries to the outpatient sector. The transition of arthroscopic and open shoulder and elbow surgeries to outpatient care presents both opportunities and risks. However, there is a need for improvement in the flexibility for medically necessary inpatient treatments, the management of infrastructural challenges in hospitals, and ensuring high-quality surgical training in a changing healthcare landscape.