title: [Establishing an Ambulatory Health-Care Centre (AHCC) at a University Hospital].
abstract: BACKGROUND
  Since January 2004 hospitals have the opportunity to establish an ambulatory health-care centre (Medizinisches Versorgungszentrum - MVZ) as a result of the introduction of the Health-care Modernisation Act (Gesetz zur Modernisierung der gesetzlichen Krankenversicherung - GMG). After about a half-year preparatory phase, the UKE, in September 2004, began operation of the "Ambulanzzentrum des UKE GmbH" (a limited liability company) as the first MVZ at a university hospital in Germany. We report here on the establishment of the MVZ and the experience made.
  
  
  METHODS
  In the initial phase, only the medical fields of radiation therapy and nuclear medicine were represented. Both disciplines, especially radiation therapy, were existentially threatened by the extensive loss of ambulatory patients. The central motive for the establishment of the ambulatory health-care centre was to secure the survival of both disciplines and to preserve existing jobs. After it was put into operation, the referrals from practice-based colleagues to both radiation therapy and nuclear medicine increased quickly. The positive developments caused other departments of the UKE to express their interest in supplementing their outpatient activities with facilities in the MVZ.
  
  
  RESULTS
  Over the following years, the ambulance centre grew steadily. Now 24 departments are represented in the MVZ, and the centre has a total of 49 positions for physicians contracted by and registered within the German public health insurance system. The number of salaried doctors has risen to 85, although many of these only work part time in the MVZ. Also more than 83 non-medical staff members were hired over the years. These were mostly physiotherapists, radiographers, and medical assistants. With the growing number of departments in the MVZ, the number of treated cases grew steadily. Currently approximately 20 000 cases are treated in each quarter of a year.
  
  
  CONCLUSIONS
  The experience made while establishing an ambulatory health-care centre is very positive. Better cross-sectoral medicine, support of referring practice-based colleagues, content of centre-physicians and a strengthening of research and teaching summarise the experience of the last 7 years accurately. The outpatient centre of UKE GmbH will strive to continue to expand its range of medical services into other medical fields whenever it makes sense.
authors.affiliation: UKE, Geschäftsführung Ambulanzzentrum, Hamburg, Deutschland. kruell@uke.uni-hamburg.de
authors.forename: A
authors.initials: A
authors.lastname: Krüll
authors.forename: J F
authors.initials: JF
authors.lastname: Debatin
mesh_terms: D003284:Contract Services / Q000331:legislation & jurisprudence / Q000458:organization & administration; D003299:Cooperative Behavior; D004501:Education, Medical / Q000331:legislation & jurisprudence / Q000458:organization & administration; D005858:Germany; D006276:Health Facility Size / Q000331:legislation & jurisprudence / Q000458:organization & administration; D006282:Health Personnel / Q000331:legislation & jurisprudence / Q000458:organization & administration; D006785:Hospitals, University / Q000331:legislation & jurisprudence* / Q000458:organization & administration*; D006801:Humans; D033183:Interdisciplinary Communication; D009313:National Health Programs / Q000331:legislation & jurisprudence*; D009683:Nuclear Medicine / Q000331:legislation & jurisprudence / Q000458:organization & administration; D010044:Outpatient Clinics, Hospital / Q000331:legislation & jurisprudence* / Q000458:organization & administration*; D011878:Radiotherapy; D012017:Referral and Consultation / Q000331:legislation & jurisprudence / Q000458:organization & administration; D012106:Research / Q000331:legislation & jurisprudence / Q000458:organization & administration; D012922:Social Change; D000078329:Workforce