Ambulatory surgery in Germany is mostly performed in private units like day clinics, specialized doctor's offices and ambulatory surgery centres. In contrast, hospitals prefer inpatient treatment. Their hierarchical system often inhibited introduction of new techniques like endo-microsurgery.
Total costs of tracer procedures are half in private units as compared to hospitals, and this at the same quality level. This points to an inherent inefficiency of the hospital system for most procedures that can be handled on an ambulatory base.
Keywords: Hospital system; Staff organisation; Day clinics; Quality assessment system; Patient questionnaires; Total costs per case; Costs per operating hour; DRG-based fees