[Simulation of possible effects of the Hospital Care Improvement Act on inpatient care in ENT medicine].

A fundamental hospital reform is urgently needed due to the existing shortage of specialists, postpandemic productivity changes, and increasing financial deficits faced by hospitals in Germany. Starting from a hospital reform initiated in North-Rhine Westphalia (NRW), the so-called Hospital Care Improvement Act ("Krankenhausversorgungsverbesserungsgesetz", KHVVG) was launched at the federal level with the aim of ensuring more adequate funding, safeguarding and improving treatment quality, and reducing bureaucracy. This was passed by the Federal Council and officially came into force on 1 January 2025. For the specialty of Otorhinolaryngology, two categories-general ENT and cochlear implants-were selected for future hospital planning. The new law also established minimum physician requirements (e.g., 3 full-time physicians including 24/7 on-call duty) and defines so-called "oncological capping" as well as minimum number of cases for each defined entity. These measures are expected to lead to significant changes in the hospital landscape, including centralization of highly specialized services, with potential implications for specialist training. In summary, the KHVVG will ultimately alter patient care, thus, requiring flexible adaptation processes, which will be supported by professional societies. For this reason, we have simulated and discussed the effects of the KHVVG on our field to better assess possible consequences and initiate adjustment processes at an early stage.