{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:09:04Z","timestamp":1792782544945,"version":"4.5.0"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"12","license":[{"start":{"date-parts":[[2023,10,26]],"date-time":"2023-10-26T00:00:00Z","timestamp":1698278400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,10,26]],"date-time":"2023-10-26T00:00:00Z","timestamp":1698278400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Medizinische Hochschule Brandenburg CAMPUS gGmbH"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Chirurgie"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Hintergrund<\/jats:title>\n                    <jats:p>In der Viszeralchirurgie wurden die Mindestmengen (Mm) f\u00fcr komplexe Eingriffe am \u00d6sophagus und Pankreas 2023 bzw. 2025 angehoben. Kliniken, die die Mm nicht erreichen, d\u00fcrfen diese Eingriffe nicht mehr durchf\u00fchren und haben keinen Verg\u00fctungsanspruch.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ziel der Arbeit<\/jats:title>\n                    <jats:p>Die Studie beantwortet die Fragen, welche Auswirkungen die an der Versorgung im Land Brandenburg Beteiligten durch die neuen Mm erwarten und welche L\u00f6sungsans\u00e4tze sie f\u00fcr das d\u00fcnn besiedelte Fl\u00e4chenland sehen.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material und Methoden<\/jats:title>\n                    <jats:p>Es wurden 19\u00a0Expert:inneninterviews mit Krankenhausangestellten (Chef\u00e4rzt:innen, Ober\u00e4rzt:innen, Pflegedirektor:innen), niedergelassenen \u00c4rzt:innen und Patient:innenvertretungen im Zeitraum 07\/2022 bis 01\/2023 durchgef\u00fchrt. Die Datenauswertung erfolgte inhaltsanalytisch.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ergebnisse<\/jats:title>\n                    <jats:p>Die Interviewten erwarteten f\u00fcr die operative Versorgung eine Umverteilung in wenige Kliniken (Zentren); hingegen w\u00fcrden mehr Kliniken, die die komplexen Operationen nicht (mehr) durchf\u00fchren d\u00fcrfen, die Funktion von \u201ePortalkliniken\u201c f\u00fcr die Basisversorgung, Diagnostik und Nachsorge \u00fcbernehmen. Die Umverteilung k\u00f6nnte auch Auswirkungen auf nicht direkt von der Mm-Regelung betroffene Behandlungen haben. Die Erh\u00f6hung der Mm habe au\u00dferdem Auswirkungen auf die Weiterbildung und Personalgewinnung. Als L\u00f6sungsvorschlag wurden insbesondere Kooperationen zwischen verschiedenen Kliniken diskutiert, die strukturell zun\u00e4chst gef\u00f6rdert werden m\u00fcssten.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Diskussion<\/jats:title>\n                    <jats:p>Mm beeinflussen nicht nur Ergebnisqualit\u00e4t und Erreichbarkeit, sondern ziehen eine Vielzahl weiterer Effekte nach sich. Insbesondere f\u00fcr d\u00fcnn besiedelte Regionen stellen Mm Herausforderungen f\u00fcr den Zugang zu \u00d6sophagus- und Pankreasoperationen sowie die Kommunikation zwischen Zentren und Portalkliniken bzw. ambulanten Versorger:innen dar.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00104-023-01971-1","type":"journal-article","created":{"date-parts":[[2023,10,26]],"date-time":"2023-10-26T09:02:16Z","timestamp":1698310936000},"page":"1015-1021","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Auswirkungen der neuen Mindestmengen in der Viszeralchirurgie auf die Gesundheitsversorgung in Brandenburg aus der Perspektive der Versorger:innen","Effects of new minimum volume standards in visceral surgery on healthcare in Brandenburg, Germany, from the perspective of healthcare providers"],"prefix":"10.1007","volume":"94","author":[{"given":"C. M.","family":"Kugler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Gretschel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Scharfe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Pfisterer-Heise","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Mantke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Pieper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,10,26]]},"reference":[{"key":"1971_CR1","unstructured":"AOK Bundesverband (2022) Mindestmengen-Transparenzliste 2023. Berlin"},{"key":"1971_CR2","first-page":"739","volume":"116","author":"P Baum","year":"2019","unstructured":"Baum\u00a0P, Diers\u00a0J, Lichthardt\u00a0S et\u00a0al (2019) Mortality and complications following visceral surgery: a\u00a0nationwide analysis based on the diagnostic categories used in German hospital invoicing data. Dtsch \u00c4rztebl Int 116:739\u2013746","journal-title":"Dtsch \u00c4rztebl Int"},{"key":"1971_CR3","doi-asserted-by":"publisher","first-page":"1041","DOI":"10.1200\/JCO.21.01488","volume":"40","author":"P Baum","year":"2022","unstructured":"Baum\u00a0P, Lenzi\u00a0J, Diers\u00a0J et al (2022) Risk-adjusted mortality rates as a\u00a0quality proxy outperform volume in surgical oncology\u2014a new perspective on hospital centralization using national population-based data. J\u00a0Clin Oncol 40:1041\u20131050","journal-title":"J Clin Oncol"},{"key":"1971_CR4","doi-asserted-by":"publisher","first-page":"362","DOI":"10.1007\/s00104-022-01606-x","volume":"93","author":"S Benz","year":"2022","unstructured":"Benz\u00a0S (2022) Mindestmengen aus der Sicht des Spezialisten am kleineren Haus. Chirurg 93:362\u2013368","journal-title":"Chirurg"},{"key":"1971_CR5","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1177\/13558196221082585","volume":"27","author":"GB Black","year":"2022","unstructured":"Black\u00a0GB, Wood\u00a0VJ, Ramsay\u00a0AIG et\u00a0al (2022) Loss associated with subtractive health service change: The case of specialist cancer centralization in England. J\u00a0Health Serv Res Policy 27:301\u2013312","journal-title":"J Health Serv Res Policy"},{"key":"1971_CR6","doi-asserted-by":"publisher","first-page":"884","DOI":"10.1016\/S0140-6736(15)60087-3","volume":"386","author":"BS Brooke","year":"2015","unstructured":"Brooke\u00a0BS, Goodney\u00a0PP, Kraiss\u00a0LW et\u00a0al (2015) Readmission destination and risk of mortality after major surgery: an observational cohort study. Lancet 386:884\u2013895","journal-title":"Lancet"},{"key":"1971_CR7","unstructured":"https:\/\/www.berlin-brandenburg.de\/hauptstadtregion\/daten-und-fakten\/#:~:text=Der%20Weitere%20Metropolenraum%20schlie%C3%9Ft%20an. Zugegriffen: 15. Juni 2023"},{"key":"1971_CR8","unstructured":"https:\/\/www.g-ba.de\/downloads\/39-261-4622\/2020-12-17_Mm-R_Oesophagus_BAnz.pdf. Zugegriffen: 31. Mai 2023"},{"key":"1971_CR9","unstructured":"https:\/\/www.g-ba.de\/downloads\/39-261-5206\/2021-12-16_Mm-R_Aenderung-Pankreas-Eingriffe_BAnz.pdf Zugegriffen: 31. Mai 2023"},{"key":"1971_CR10","doi-asserted-by":"publisher","first-page":"e102","DOI":"10.1097\/SLA.0000000000004432","volume":"276","author":"SWL De Geus","year":"2022","unstructured":"De Geus\u00a0SWL, Hachey\u00a0KJ, Nudel\u00a0JD et al (2022) Volume of pancreas-adjacent operations favorably influences Pancreaticoduodenectomy outcomes at lower volume pancreas centers. Ann Surg 276:e102\u2013e107","journal-title":"Ann Surg"},{"key":"1971_CR11","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1186\/s13012-016-0445-z","volume":"11","author":"NJ Fulop","year":"2016","unstructured":"Fulop\u00a0NJ, Ramsay\u00a0AI, Perry\u00a0C et\u00a0al (2016) Explaining outcomes in major system change: a\u00a0qualitative study of implementing centralised acute stroke services in two large metropolitan regions in England. Implement Sci 11:80","journal-title":"Implement Sci"},{"key":"1971_CR12","unstructured":"Gemeinsamer Bundesausschuss (2023) Regelungen des Gemeinsamen Bundesausschusses gem\u00e4\u00df \u00a7\u00a0136b Absatz\u00a01 Satz\u00a01 Nummer 2 SGB\u00a0V f\u00fcr nach \u00a7\u00a0108 SGB\u00a0V zugelassene Krankenh\u00e4user Berlin"},{"key":"1971_CR13","doi-asserted-by":"publisher","first-page":"1158","DOI":"10.1016\/j.amjmed.2022.04.005","volume":"135","author":"AN Iness","year":"2022","unstructured":"Iness\u00a0AN, Abaricia\u00a0JO, Sawadogo\u00a0W et al (2022) The effect of hospital visitor policies on patients, their visitors, and health care providers during the COVID-19 pandemic: a\u00a0systematic review. Am J Med 135:1158\u20131167.e1153","journal-title":"Am J Med"},{"key":"1971_CR14","unstructured":"Iqtig (2020) Folgenabsch\u00e4tzung Mindestmengen Komplexe Eingriffe am Organsystem \u00d6sophagus Berlin"},{"key":"1971_CR15","unstructured":"Iqtig (2021) Folgenabsch\u00e4tzungen zu Mindestmengen Komplexe Eingriffe am Organsystem Pankreas Berlin"},{"key":"1971_CR16","doi-asserted-by":"publisher","unstructured":"Kugler CM, Gretschel S, Scharfe J, Pfisterer-Heise S, Pieper D (2022) Effects of new minimum volume thresholds in visceral surgery on care in the federal state of Brandenburg, Germany. https:\/\/doi.org\/10.17605\/OSF.IO\/7GYU5","DOI":"10.17605\/OSF.IO\/7GYU5"},{"key":"1971_CR17","doi-asserted-by":"crossref","unstructured":"Krautz C, Gr\u00fctzmann R (2022) Mindestmengen aus der Sicht des universit\u00e4ren Versorgers. Chirurg 93:349\u2013355","DOI":"10.1007\/s00104-022-01604-z"},{"key":"1971_CR18","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1007\/s00104-022-01596-w","volume":"93","author":"H Lang","year":"2022","unstructured":"Lang\u00a0H, Grimminger\u00a0PP, Meyer\u00a0H\u2011J (2022) Mindestmengenregelungen in der Chirurgie aus Sicht der Fachgesellschaft (DGCH). Chirurg 93:342\u2013348","journal-title":"Chirurg"},{"key":"1971_CR19","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1002\/bjs5.50115","volume":"3","author":"N Latchana","year":"2019","unstructured":"Latchana\u00a0N, Davis\u00a0L, Coburn\u00a0NG et al (2019) Population-based study of the impact of surgical and adjuvant therapy at the same or a\u00a0different institution on survival of patients with pancreatic adenocarcinoma. BJS Open 3:85\u201394","journal-title":"BJS Open"},{"key":"1971_CR20","volume-title":"Qualitative Inhaltsanalyse: Grundlagen und Techniken","author":"P Mayring","year":"2015","unstructured":"Mayring\u00a0P (2015) Qualitative Inhaltsanalyse: Grundlagen und Techniken. Beltz, Weinheim"},{"key":"1971_CR21","unstructured":"https:\/\/www.mags.nrw\/krankenhausplanung-neuer-krankenhausplan. Zugegriffen: 13. Juni 2023"},{"key":"1971_CR22","first-page":"793","volume":"115","author":"U Nimptsch","year":"2018","unstructured":"Nimptsch\u00a0U, Haist\u00a0T, Krautz\u00a0C et al (2018) Hospital volume, in-hospital mortality, and failure to rescue in esophageal surgery. Dtsch Arztebl Int 115:793\u2013800","journal-title":"Dtsch Arztebl Int"},{"key":"1971_CR23","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1007\/s00104-021-01557-9","volume":"93","author":"NC N\u00fcssler","year":"2022","unstructured":"N\u00fcssler\u00a0NC, Klier\u00a0T, Ruppert\u00a0R (2022) Mindestmengen aus der Sicht einer Klinik der Schwerpunktversorgung. Chirurg 93:356\u2013361","journal-title":"Chirurg"},{"key":"1971_CR24","doi-asserted-by":"publisher","first-page":"1015","DOI":"10.1016\/j.jamcollsurg.2012.12.049","volume":"216","author":"D Pieper","year":"2013","unstructured":"Pieper\u00a0D, Mathes\u00a0T, Neugebauer\u00a0E et al (2013) State of evidence on the relationship between high-volume hospitals and outcomes in surgery: a\u00a0systematic review of systematic reviews. J\u00a0Am Coll Surg 216:1015\u20131025.e1018","journal-title":"J Am Coll Surg"},{"key":"1971_CR25","doi-asserted-by":"publisher","first-page":"e001051","DOI":"10.1136\/esmoopen-2020-001051","volume":"5","author":"J Prades","year":"2020","unstructured":"Prades\u00a0J, Arnold\u00a0D, Brunner\u00a0T et\u00a0al (2020) Bratislava Statement: consensus recommendations for improving pancreatic cancer care. ESMO Open 5:e1051","journal-title":"ESMO Open"},{"key":"1971_CR26","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1007\/s00104-022-01738-0","volume":"94","author":"J Schardey","year":"2023","unstructured":"Schardey\u00a0J, Huber\u00a0T, Kappenberger\u00a0AS et al (2023) Erwartete Effekte der neuen Weiterbildungsordnung in der Allgemein- und Viszeralchirurgie. Chirurgie 94:155\u2013163 ((Heidelb))","journal-title":"Chirurgie"},{"key":"1971_CR27","unstructured":"Schoffer O, R\u00f6\u00dfler M, Bierbaum V (2022) Ergebnisbericht. In: Wirksamkeit der Versorgung in onkologischen Zentren (WiZen), Gemeinsamer Bundesausschuss, Berlin. https:\/\/innovationsfonds.g-ba.de\/downloads\/beschluss-dokumente\/268\/2022-10-17_WiZen_Ergebnisbericht.pdf"},{"key":"1971_CR28","doi-asserted-by":"publisher","first-page":"2537","DOI":"10.1245\/s10434-010-1114-0","volume":"17","author":"M Simunovic","year":"2010","unstructured":"Simunovic\u00a0M, Urbach\u00a0D, Major\u00a0D et al (2010) Assessing the volume-outcome hypothesis and region-level quality improvement interventions: pancreas cancer surgery in two Canadian provinces. Ann Surg Oncol 17:2537\u20132544","journal-title":"Ann Surg Oncol"},{"key":"1971_CR29","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1038\/bjc.2017.180","volume":"117","author":"M Turner","year":"2017","unstructured":"Turner\u00a0M, Fielding\u00a0S, Ong\u00a0Y et al (2017) A cancer geography paradox? Poorer cancer outcomes with longer travelling times to healthcare facilities despite prompter diagnosis and treatment: a\u00a0data-linkage study. Br J Cancer 117:439\u2013449","journal-title":"Br J Cancer"},{"key":"1971_CR30","doi-asserted-by":"publisher","first-page":"524","DOI":"10.1016\/j.ejso.2018.01.001","volume":"44","author":"M Varagunam","year":"2018","unstructured":"Varagunam\u00a0M, Hardwick\u00a0R, Riley\u00a0S et al (2018) Changes in volume, clinical practice and outcome after reorganisation of oesophago-gastric cancer care in England: a\u00a0longitudinal observational study. Eur J Surg Oncol 44:524\u2013531","journal-title":"Eur J Surg Oncol"}],"container-title":["Die Chirurgie"],"original-title":[],"language":"de","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00104-023-01971-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00104-023-01971-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00104-023-01971-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,30]],"date-time":"2023-11-30T06:02:37Z","timestamp":1701324157000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00104-023-01971-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,26]]},"references-count":30,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2023,12]]}},"alternative-id":["1971"],"URL":"https:\/\/doi.org\/10.1007\/s00104-023-01971-1","relation":{},"ISSN":["2731-6971","2731-698X"],"issn-type":[{"value":"2731-6971","type":"print"},{"value":"2731-698X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,26]]},"assertion":[{"value":"13 September 2023","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 October 2023","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Einhaltung ethischer Richtlinien"}},{"value":"S.\u00a0Gretschel und R.\u00a0Mantke leiten die Chirurgische Abteilung zweier Krankenh\u00e4user in Brandenburg. Ihre Abteilungen sind direkt durch die \u00c4nderungen der Mindestmengenregelung betroffen. C.M.\u00a0Kugler, J.\u00a0Scharfe, S.\u00a0Pfisterer-Heise und D.\u00a0Pieper geben an, dass kein Interessenkonflikt besteht.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Interessenkonflikt"}},{"value":"Die zust\u00e4ndige Ethikkommission der Medizinischen Hochschule Brandenburg best\u00e4tigte, dass f\u00fcr die Durchf\u00fchrung der Expert:innen-Interviews keine Beratungspflicht besteht (Waiver E\u201103-20220623). Alle Teilnehmenden haben eine Studieninformation und Datenschutzerkl\u00e4rung erhalten und vor der Teilnahme eine Einwilligungserkl\u00e4rung unterschrieben.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Interessenkonflikt"}}]}}