The dialogue partners
Prof. Dr. Patrick Da-Cruz is Professor of Business Administration and Healthcare Management at the Faculty of Healthcare Management at Neu-Ulm University of Applied Sciences (HNU) and Academic Director of the MBA programme Leadership and Management in Healthcare.
Before joining the HNU, Mr Da-Cruz worked for well-known strategy consultancies in the pharmaceutical/healthcare sector and in management positions in companies in the healthcare industry in Germany and abroad.
Dr. med. Jannis Vitzthum is Director Medtronic Integrated Health Solutions DACH. As a doctor with several years of clinical and consulting experience (including McKinsey and Deloitte), he is an expert in healthcare topics, particularly in the area of change management.
![[Translate to English:] Porträtfoto von Dr. med. Jannis Vitzthum](/fileadmin/_processed_/c/d/csm_Jannis%20Vitzthum%20foto_db9bd21a5c.jpg)
What is meant by the term "ambulantisation"? Why has the topic gained in importance in recent years?
Jannis Vitzthum, MD: Outpatient care refers to the shift of medical services from inpatient to outpatient care. This trend has become increasingly important in recent years, as it represents a cost-effective alternative to inpatient care and strengthens medical care, particularly in rural areas. Our European neighbours are already much further ahead in this respect; many examinations and procedures that are still performed in hospital in Europe are now generally only provided on an outpatient basis. As we can see from European examples such as in the Netherlands or the Nordic countries, all groups can in principle benefit from this transformation.
What opportunities and risks are associated with outpatientisation for hospitals?
Jannis Vitzthum, MD: Hospitals can benefit from outpatient treatment by concentrating on serious and complex treatments, thereby increasing their efficiency. However, outpatientisation can also lead to an overload in the outpatient sector, which can result in an additional burden for doctors in private practice. This means that there must not be a pure shift of services to the surgeries, as this would not work. And ultimately it represents an economic factor that relieves the burden on the healthcare system and thus society as a whole.
What opportunities and risks are associated with outpatient treatment for patients?
Jannis Vitzthum, MD: For patients, outpatient treatment offers the advantage that they can be treated in their familiar surroundings and do not have to stay overnight in hospital. The risk of contracting a nosocomial infection, i.e. an infection caused by the hospital environment, is also reduced if the stay is minimised. However, this can also lead to a shorter follow-up period and poorer training of junior staff in hospital. It is therefore important to completely rethink future patient pathways rather than simply reducing the length of hospitalisation "to zero days". This can be achieved - and there is a lot of scientific evidence for this - by optimising patient preparation and using new technologies such as telemedicine or patient apps. For example, a patient can now send a query and a photo of the wound to the hospital, and other important parameters can be monitored remotely to give patients the security they need in the event of an emergency.
What role does the issue of remuneration play in outpatient treatment?
Jannis Vitzthum, MD: The issue of remuneration naturally plays an important role in outpatient treatment. Services that are provided in hospital currently still generate many times more revenue than the same service provided on an outpatient basis. For all services in the extended AOP catalogue, the contractual partners - the National Association of Statutory Health Insurance Funds, the German Hospital Federation and the National Association of Statutory Health Insurance Physicians - are to agree remuneration that is identical for hospitals and panel doctors and only varies according to the severity of the treatment case.
Can outpatient treatment help to combat the shortage of specialists?
Jannis Vitzthum, MD: Yes, absolutely - outpatient treatment can help combat the shortage of specialists. The efficient structures of successful outpatient care could make an important contribution to combating the increasing shortage of specialists. For hospital service providers, doctors and carers, it can bring significant relief - the personnel costs for pure "overnight stays", even without medical services, are very high, if only due to the administrative effort and documentation, for example.
Thank you very much for talking to us!
