[Implications of the federal hospital reform : Structural requirements, service groups, and the role of certified quality systems illustrated by the example of endoprosthetics].

backgroundWith the Hospital Care Improvement Act (KHVVG), the legislator aims to ensure quality-oriented and needs-based inpatient care through structural minimum requirements and the introduction of service groups. Frequently performed surgical procedures such as endoprosthetic joint replacement are intended to become more specialized and concentrated. RESEARCH QUESTION: To what extent do the service groups defined in the KHVVG and the Hospital Reform Adjustment Act (KHAG) actually ensure verifiable quality of care, and what role can established quality systems play in this context? MATERIALS AND

methodsA comparative analysis of the service group requirements for hip endoprosthetics was performed with regard to structural, process, and outcome quality. These requirements were subjected to a gap analysis and compared with the quality standards of the certified quality system EndoCert.

resultsThe statutory requirements focus almost exclusively on structural minimum standards. Indicators of process and outcome quality, external audits, and mandatory participation in registries are not scheduled. In contrast, EndoCert provides an established, externally audited system of validated quality indicators with nationwide coverage.

conclusionThe hospital reform addresses structural prerequisites but remains incomplete with regard to practical quality assurance. The integration of existing quality systems such as EndoCert could represent a low-bureaucracy, data-driven, and transparent complement to the reform. EndoCert can also serve as a quality management tool to optimize internal clinical quality processes.