Aim: To compare ambulatory surgery (AS) in hospitals and free standing units with regard to efficiency, quality and other indicators.
Results: Two-thirds of ambulatory procedures in Germany are performed in day clinics, one third in hospitals.There are equal competitive conditions for AS concerning structural quality, hygiene and payment. Diverging conditions exist in the fields of ownership structure, capital investment and training of workforce. A number of studies shows that ambulatory surgery in small free standing units is the most efficient way to perform surgery with high patient satisfaction.
Conclusion: Political and economic interests are the main obstacles on the way to a more efficient health care system.
Keywords: Ambulatory surgery, office based surgery, health care system, payment system.