[德国门诊外科治疗面临的挑战]。

Chirurgie (Heidelberg, Germany) Pub Date : 2025-07-01 Epub Date: 2025-03-05 DOI:10.1007/s00104-025-02263-6
Johannes Klose, Claudia Rudroff, Lars Fischer, Artur Rebelo, Jörg Kleeff, Ralf Michael Wilke
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引用次数: 0

摘要

背景:在德国,门诊和日间门诊手术在外科服务提供中的比例仍在增加。最近,修订了门诊手术可进行的手术目录,并实行了部门间报酬制度;然而,外科部门增加门诊服务的先决条件是非常不同的。目的:本研究的目的是分析德国普通外科和内脏外科门诊护理的现状和挑战。材料与方法:构建包含26个问题的门诊手术治疗结构现状调查问卷,调查门诊条件下进行手术培训的可能性。问卷通过德国普通与内脏外科学会和高级医院外科医师协会(Konvent der leitenden Krankenhauschirurginnen und -chirurgen)的电子邮件列表发送,并对完成的问卷进行分析。结果:共有204名主任医师参与调查。54.4%的外科医生负责基本护理医院,其次是专科医院和最高护理医院。95.5%的医院存在门诊结构,医疗保健中心比例较高。尽管缺乏全面的结构,大多数外科医生仍计划扩大门诊服务。即使没有针对初级医生的结构化教育课程,也有高达70%的门诊手术是由初级医生完成的。70%的参与者评价德国门诊手术护理的现状为薄弱。预计不会因执行新的部门间薪酬而有所改善。讨论:在医院景观中,门诊手术的结构表现出明显的差异。结论:三分之二的参与者认为,尽管现有的基础设施,他们的医院没有为增加提供门诊服务做好充分准备,并评估相关报酬不足。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

[Challenges in outpatient surgical treatment in Germany].

[Challenges in outpatient surgical treatment in Germany].

[Challenges in outpatient surgical treatment in Germany].

[Challenges in outpatient surgical treatment in Germany].

Background: In Germany the proportion of outpatient and day clinic surgery within the surgical service provision is still increasing. Recently, the catalogue of operations which can be carried out in outpatient surgery was revised and an intersectoral remuneration was introduced; however, the prerequisites in the surgical departments for an increased provision of outpatient services are very heterogeneous.

Objective: The aim of this study was to analyze the current situation and challenges of outpatient care in general and visceral surgery in Germany.

Material and methods: A questionnaire with 26 questions on the current situation of the treatment structure for outpatient surgery was constructed and the possibility for surgical training under outpatient conditions was surveyed. The questionnaire was digitally sent via the mailing list of the German Society for General and Visceral Surgery and the Convention of Senior Hospital Surgeons (Konvent der leitenden Krankenhauschirurginnen und -chirurgen) and the completed questionnaires were analyzed.

Results: A total of 204 head physicians took part in the survey. In 54.4% the surgeons were in charge of basic care hospitals followed by specialized and maximum care hospitals. An outpatient structure was present in 95.5% of the hospitals with a high proportion of medical care centers. The majority of the surgeons planned to extend outpatient services despite the lack of comprehensive structures. Even if a structured education curriculum for junior doctors does not exist up to 70% of outpatient operations are performed by junior doctors. The current status of outpatient surgery care in Germany was evaluate as weak by 70% of the participants. An improvement due to the implementation of a new intersectoral remuneration is not expected.

Discussion: Within the hospital landscape the structures for outpatient surgery show clear differences.

Conclusion: Of the participants two thirds felt that despite the existing infrastructure their hospital was not well-prepared for the increased provision of outpatient services and assessed the associated remuneration as insufficient.

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