Strategy and Realignment

In light of demographic developments, a shortage of skilled workers, and growing healthcare needs, outpatient care in Germany is under considerable pressure. At the same time, outpatient care is increasingly becoming a political focus. This article analyzes the associated challenges and presents international models that offer innovative solutions, including multi-professional teams, mobile care, expanded roles for non-medical professions, digital applications, and regional management approaches. Successful practical examples such as the “PORT” program or “Gesundes Kinzigtal” show how such concepts can also be effectively implemented in this country. However, clear legal, financial, and structural framework conditions are necessary for sustainable transformation. The article calls for a rethinking of the organization of care and outlines principles for sustainable outpatient care.

Outpatient care under pressure

Outpatient care is the cornerstone of our healthcare system. But its structures are faltering: on the one hand, more and more elderly patients require continuous care, while on the other hand, there is a shortage of doctors in many regions. At the same time, services that were previously provided on an inpatient basis are being shifted to the outpatient sector, which is overwhelming existing practices and care services in many places.

Care needs new answers

“The sharp divide between outpatient and inpatient care makes coordination difficult. There is a lack of binding interfaces, digital communication, and uniform control.”

Innovative concepts show perspectives

Other countries are showing how things can be done better: Doctors work in multi-professional teams with nurses and therapists. Digital platforms ensure the flow of information, mobile units bring care to structurally weak regions, and expanded roles for nurses create additional capacity. The key factor here is always cooperation: responsibility is shared, processes are coordinated, and resources are used in a targeted manner.

German projects provide impetus

Here in Germany, too, models are emerging that show that a reorientation is possible. In the Robert Bosch Stiftung's PORT centers, health and social care professionals work together and test expanded nursing competencies. In the “Gesundes Kinzigtal” (Healthy Kinzigtal) project, doctors, health insurance companies, and other partners have been sharing responsibility for years – with noticeable effects on quality, efficiency, and patient satisfaction.

The future needs reliable framework conditions

The examples show that outpatient care can be rethought. However, for pilot projects to lead to widespread change, stable financing, clear legal foundations, and a digital infrastructure that enables genuine networking are essential. Only then can innovative concepts be implemented sustainably.