AOP catalog is just the first step towards outpatient care
04.04.2022 10:30
The use of outpatient potential will be an essential prerequisite for ensuring long-term economical and high-quality care in Germany. The coalition agreement also addresses outpatient care as an important part of the intended structural reform. With the publication of the report on the expansion of the previous AOP catalog, an important step is being taken here.
“We welcome the result of the report on the adaptation and expansion of the AOP catalog and support the approach that goes well beyond simply adapting the catalog. We are convinced that the use of the outpatient potential of hospitals will be a real added value for patient care in the future,” explained Dr. Gerald Gaß, Chairman of the Board of the German Hospital Association (DKG).
The report that has now been published fulfills the task of examining the state of medical knowledge regarding operations that can be performed on an outpatient basis, ward-replacing procedures and ward-replacing treatments. In addition, the report should specifically name outpatient operations, ward-replacing interventions and ward-replacing treatments in order to expand the catalog according to Section 115b SGB V and, in connection with this, analyze various measures to differentiate cases according to severity.
This includes outpatient operations and ward-replacing procedures as well as ward-replacing treatments. What is important in the report is the introduction of so-called contextual factors. This context factor model is the basis for a patient-specific justification for inpatient service provision, even if the service could potentially be provided on an outpatient basis. It should also be the basis for the legally required severity differentiation for a remuneration model that is still to be developed.
This area of the report is based on international experience, which shows that complex outpatient care in hospitals is possible if the framework conditions are set correctly. But it also shows that hospitals are the right place for these treatments because they are the only places where the necessary structural requirements exist.
“Thanks to the potential-oriented approach chosen, the report offers good approaches beyond the recommendations for expanding the previous AOP catalogue, on the basis of which a catalog of ward-replacing services can be defined for a new clinical outpatient area and in which hospitals will in future be able to evaluate medical aspects decide for themselves whether they provide this service on an outpatient or inpatient basis. Such a clinical-outpatient service area at hospitals can ideally be remunerated with the hybrid DRG mentioned in the coalition agreement. This creates strong incentives for outpatient services that were previously fully inpatient and focuses solely on medical aspects when choosing the treatment location for each patient,” says Gaß.