title: [Medical care unit -- a suitable instrument for ambulatory patient-adequate care and performance-related remuneration].
abstract: BACKGROUND
  The question of whether a medical care unit is an appropriate tool for outpatient care has been discussed for a long time. Our aim is to investigate whether the MCU is an effective instrument for outpatient care and adequate performance-related remuneration.
  
  
  METHODS
  This retro- and prospective overview of the work included statements on legal foundations for medical care units, for reimbursement of services in medical care units, the development of medical care centres in Germany and a listing of the specific advantages and disadvantages of an MCU. This article focuses on the generally applicable facts and complements them with examples from general, visceral and vascular surgery. The main quantitative data on medical centre statistics come from different publications of the National Association of Statutory Health Insurance for Physicians.
  
  
  RESULTS
  From a legal point of view the instrument MCU allows the participating of ambulatory and stationary care in the framework of medical care contracts. This has been especially extended for stationary applications, including the spectrum of possibilities that can contribute under certain circumstances for the provision of medical care in underdeveloped regions. Freelancers can benefit primarily from financial risk and minimising bureaucratic routine. The remuneration for services performed in the MCU is analogous to that of other ambulatory care providers. Basically, there are no disadvantages, but a greater design freedom and opportunities for the generation of aggregates are visible. The number of MCU in Germany has quadrupled in the last five years, indicating an establishment of an outpatient care landscape. MCU offers from the patient's perspective, providers and policy specific advantages and disadvantages. Indeed the benefits outweigh the disadvantages, but this is not yet verified by qualitative studies.
  
  
  CONCLUSIONS
  The question of the appropriateness of medical care units as outpatient care instrumentation must be considered differentially. Under current conditions it appears suitable for ensuring the MCU and the supplement of care supply. Whether a value can be generated in the quality of care of patients, however, has to be examined separately, as there are no valid data so far. The same applies to economic assessments of costs and benefits from an economic perspective.
authors.affiliation: Hochschule Magdeburg-Stendal, Fachbereich Sozial- und Gesundheitswesen, Magdeburg, Deutschland. Peter.Rudolph@hs-magdeburg.de
authors.forename: P
authors.initials: P
authors.lastname: Rudolph
authors.forename: D
authors.initials: D
authors.lastname: Isensee
authors.forename: E
authors.initials: E
authors.lastname: Gerlach
authors.forename: H
authors.initials: H
authors.lastname: Gross
mesh_terms: D003284:Contract Services / Q000191:economics / Q000331:legislation & jurisprudence; D003299:Cooperative Behavior; D003362:Cost-Benefit Analysis; D013502:General Surgery / Q000191:economics / Q000331:legislation & jurisprudence; D005858:Germany; D006801:Humans; D033183:Interdisciplinary Communication; D009313:National Health Programs / Q000191:economics* / Q000331:legislation & jurisprudence; D010044:Outpatient Clinics, Hospital / Q000191:economics* / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D011446:Prospective Studies; D012052:Reimbursement, Incentive / Q000191:economics* / Q000331:legislation & jurisprudence; D060926:Remuneration; D012189:Retrospective Studies; D013043:Specialties, Surgical / Q000191:economics / Q000331:legislation & jurisprudence; D014656:Vascular Surgical Procedures / Q000191:economics / Q000331:legislation & jurisprudence; D014781:Viscera / Q000601:surgery