Developments in ambulatory surgery in orthopedics in France in 2016

Abstract

Under the new categorization introduced by the Health Authorities, ambulatory surgery (AS) in France now accounts for 50% of procedures, taking all surgical specialties together. The replacement of full hospital admission by AS is now well established and recognized. Health-care centers have learned, in coordination with the medico-surgical and paramedical teams, how to set up AS units and the corresponding clinical pathways. There is no single model handed down from above. The authorities have encouraged these developments, partly by regulations but also by means of financial incentives. Patient eligibility and psychosocial criteria are crucial determining factors for the success of the AS strategy. The surgeons involved are strongly committed. Feedback from many orthopedic subspecialties (shoulder, foot, knee, spine, hand, large joints, emergency and pediatric surgery) testify to the rise of AS, which now accounts for 41% of all orthopedic procedures. Questions remain, however, concerning the role of the GP in the continuity of care, the role of innovation and teaching, the creation of new jobs, and the attractiveness of AS for surgeons. More than ever, it is the patient who is "ambulatory", within an organized structure in which surgical technique and pain management are well controlled. Not all patients can be eligible, but the AS concept is becoming standard, and overnight stay will become a matter for medical and surgical prescription.

The development of one-day surgical care in Hungary between 2010 and 2019

“…Recent years have seen several reports on the low rate of Hungarian one-day surgeries in the case of the most common intervention, cataract surgery (2007–2011: > 40%) [ 31 ]. As a result of the health policy efforts of the previous decade, − taking into account all medical professions – in less than10 years, the utilization rates of Hungarian one-day surgical care already approached the level of northern European countries [ 13 , 32 ]. The country’s health policy intentions for one-day surgical care and the associated development dynamics could be well illustrated by the fact that the more economically advanced country, France, set a target of 66% market share of one-day surgical care by 2020 [ 33 ].…”

Az egynapos sebészeti ellátás igénybevételi mutatóinak elemzése Magyarországon

“…Jellemzően az észak-európai országok járnak élen az egynapos sebészeti ellátásban. Franciaországban 2010 és 2014 között az egynapos sebészeti beavatkozások aránya nem haladta meg az 50%-ot, a magyarországi eredmények ezek alapján kedvezőbbnek bizonyultak [40].…”

The developement of one-day surgical care in Hungary between 2010-2019

“…There are no currently available validated one-day surgical rates published in the international academic literature that would cover all areas of the medical professions from the neighbor countries of Hungary, but several publications address recommendations for the demand to expand one-day surgical care. 11,27 Similar to inpatient care, CMI is also an informative indicator in the performance evaluation of oneday surgery, which increased between 2010-2019 in Hungary. This could be explained by the signi cant role of university clinical centers in one-day surgical care which resulted from favorable nancing techniques that were introduced-110% basic DRG fee and PVL-free reckoning.…”