Wenke A, Pühse G, Tessarek U, Franz D
Franz und Wenke - Beratung im Gesundheitswesen GbR, Mendelstr. 11, 48149, Münster, Deutschland.
DRG-Research-Group, Münster, Deutschland.
Urologe A. 2021 Oct;60(10):1277-1290. doi: 10.1007/s00120-021-01624-3. Epub 2021 Sep 2.
With the introduction of the MDK (Medizinischer Dienst der Krankenversicherung) Reform Act, there have been multiple new regulations for hospitals, some of which are confusing and interact with one another. A major focus of the legal changes is directly or indirectly on expanding the provision of outpatient services.
It can be assumed that-as a result of the new version of the framework conditions and the AOP catalog-the relevant OPS list will be expanded in the future. With the revision of the AOP catalog and the effects of the MDK Reform Act, the number of cases with outpatient potential will increase. Can the effects and challenges for hospitals and especially urology be identified?
Evaluation of official statistics of inpatient and outpatient treatments. Focusing on the problem based on a fictitious practical example from urology.
A strategy is developed for dealing with cases with outpatient potential and identification of different solutions to compensate for this shift in services and enabling an increase in performance or a deliberate reduction in the provision of services.
The choice of the type of service provision is increasingly no longer an issue, and the short-term inpatient treatment of many urological cases is coming under considerable pressure due to political measures such as the MDK Reform Act and the demands of health insurance companies. The reduction of different parts of the inpatient reimbursement for special patient groups must be anticipated. Individual strategies will range from simply not providing outpatient services to complex models of cooperation. This change also means opportunities for hospitals!
随着《MDK（医疗保险医疗服务）改革法案》的出台，医院面临多项新规定，其中一些规定令人困惑且相互影响。法律变革的一个主要重点直接或间接地在于扩大门诊服务的提供。
可以假设，由于新版框架条件和AOP目录，相关的OPS列表未来将会扩大。随着AOP目录的修订以及MDK改革法案的影响，具有门诊治疗潜力的病例数量将会增加。能否确定对医院尤其是泌尿外科的影响和挑战？
评估住院和门诊治疗的官方统计数据。基于泌尿外科一个虚构的实际案例聚焦该问题。
制定了一种应对具有门诊治疗潜力病例的策略，并确定了不同的解决方案，以弥补服务的这种转变，并实现提高绩效或有意减少服务提供。
服务提供类型的选择越来越不再是一个问题，由于MDK改革法案等政治措施以及健康保险公司的要求，许多泌尿外科病例的短期住院治疗正面临巨大压力。必须预计到特殊患者群体住院报销不同部分的减少。个体策略将从简单地不提供门诊服务到复杂的合作模式。这种变化对医院来说也意味着机遇！
