Hospital.Help

In order to ensure the usual high quality of medical care in Germany, even with the increasing outpatientization of ophthalmology, new structures for the follow-up care of outpatients must be created, among other things. The DOG emphasized this at its recent parliamentary evening in Berlin. Ophthalmology is considered a pioneer in outpatientization. Today, around 85 percent of operations in ophthalmology are already performed on an outpatient basis. In the case of cataract operations, over 90 percent are outpatient procedures.

The DOG expressly supports the further expansion of outpatient care: “Medical progress means that there are fewer and fewer complications during procedures. As a result, a hospital stay is no longer necessary in many cases, and patients can recover from the procedure at home,” emphasizes Professor Dr. med. Claus Cursiefen, Secretary General of the DOG.

However, patient safety and ensuring high-quality care must be the clear focus when further shifting treatments and operations to the outpatient setting. “When treating severe cases or when comorbidities are present, adequate aftercare for patients must be guaranteed after an operation. To achieve this, we need other new structures in addition to the option of inpatient treatment,” says Cursiefen, who is also director of the Center for Ophthalmology at the University Hospital of Cologne.

Consider patient needs – DOG calls for eye-specific context factors

“As part of the hospital reform, we need to consider which patients can be treated on an outpatient basis and when inpatient follow-up care is required,” says Cursiefen. Patients with disabilities or those who cannot care for themselves after an operation, or those with a high risk of postoperative complications, will continue to need appropriate follow-up care in the future. “To ensure that this is also guaranteed in the event of further outpatient treatment, short-term care facilities close to the hospital that can quickly bring patients to the hospital in case of doubt must be expanded. Patient hotels close to the hospital are also conceivable,” says Professor Dr. Horst Helbig, media spokesperson for the DOG.

Until the structures for optimal outpatient aftercare for these patients are created, the DOG is calling for specific context factors to be defined for eye patients, if these factors are present, the patients can be treated as inpatients. This is because people living alone, the elderly or people who only have one eye can hardly look after themselves after an eye operation. “In order to ensure the health of all our patients, we must have the option of carrying out the treatment as inpatients in such cases,” says Cursiefen, who describes the previous context factors of the AOP catalog, which the self-administration has agreed on, as insufficient. The AOP catalog regulates which procedures can be carried out in the hospital on an outpatient basis. “We need to make the eye-specific context factors permanent.”

Good eye care is also crucial

“Nursing also plays a crucial role when it comes to a high-quality treatment outcome,” Helbig continued. Nursing staff must be able to be used flexibly in both inpatient and outpatient care. “Successful outpatient care can only be achieved if the states live up to their responsibility for investing in the conversion of clinics,” said the ophthalmologist, who is also the director of the University Eye Clinic in Regensburg. Currently, most eye clinic buildings are not optimized for outpatient procedures, so the efficiency of the procedures suffers.

Maintain established competency structures

Inpatient competence centers, such as university hospitals and other main departments, have special expertise and treatment options, such as in emergency care or the treatment of complex or rare eye diseases. “These competence centers must be maintained in the future, as they play a fundamental role in the training and further education of young people. Further outpatient care must be carefully promoted and must not be done by force,” says Cursiefen. To maintain the quality of treatment, the DOG therefore also supports the model of service groups that accompany the Hospital Care Improvement Act (KHVVG). The DOG also supports the participation of all service group billers in (operative) emergency care 24/7. “As a scientific-medical professional association, we are always happy to offer our expertise for further development,” emphasizes Cursiefen.