Outpatient management in plastic and reconstructive head and neck surgery in France. 2019

O Malard, and G Michel, and F Espitalier
Service d'ORL et de chirurgie cervico-faciale, centre hospitalier universitaire de Nantes, Hôtel-Dieu, 1, place A. Ricordeau, BP 1005, 44093 Nantes cedex 01, France. Electronic address: omalard@chu-nantes.fr.

The present review lays out the main principles governing outpatient management in the French health system in 2018, and more specifically in plastic and reconstructive head and neck surgery. The historical regulatory aspects and the changes of the last few years are explained, along with the trends and health authorities' expectations for the years to come. The main limitations to implementing outpatient procedures are the common to all surgical specialities, plastic and reconstructive head and neck surgery being no exception. Apart from purely technical aspects concerning surgical procedure and anesthesia, there are issues concerning institutional approval, the organization and continuity of health care, and the patient's environment. The French General Inspectorate of Social Affairs (IGAS), in its 2012 report on the assessment and pricing of hospital care and medical acts, stated that outpatient surgery was becoming standard practice and conventional admission a fall-back, with the aim of meeting the requirement to provide more care without more expenditure. Outpatient plastic and reconstructive head and neck surgery may be available for most patients, but still presupposes certain conditions.

UI MeSH Term Description Entries
D005602 France A country in western Europe bordered by the Atlantic Ocean, the English Channel, the Mediterranean Sea, and the countries of Belgium, Germany, Italy, Spain, Switzerland, the principalities of Andorra and Monaco, and by the duchy of Luxembourg. Its capital is Paris. Corsica,Saint Pierre and Miquelon,Miquelon and Saint Pierre,Miquelon and St. Pierre,St. Pierre and Miquelon
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000556 Ambulatory Surgical Procedures Surgery performed on an outpatient basis. It may be hospital-based or performed in an office or surgicenter. Ambulatory Surgery,Day Surgery,Office Surgery,Outpatient Surgery,Surgery, Office,Surgery, Outpatient,Ambulatory Surgical Procedure,Procedure, Ambulatory Surgical,Procedures, Ambulatory Surgical,Surgery, Ambulatory,Surgery, Day,Surgical Procedure, Ambulatory,Surgical Procedures, Ambulatory,Ambulatory Surgeries,Day Surgeries,Office Surgeries,Outpatient Surgeries,Surgeries, Ambulatory,Surgeries, Day,Surgeries, Office,Surgeries, Outpatient
D013517 Otorhinolaryngologic Surgical Procedures Surgery performed on the ear and its parts, the nose and nasal cavity, or the throat, including surgery of the adenoids, tonsils, pharynx, and trachea. Otorhinolaryngologic Surgical Procedure,Otorhinolaryngological Surgical Procedures,Procedure, Otorhinolaryngologic Surgical,Procedures, Otorhinolaryngologic Surgical,Surgical Procedure, Otorhinolaryngologic,Surgical Procedures, Otorhinolaryngologic,Otorhinolaryngological Surgical Procedure,Procedure, Otorhinolaryngological Surgical,Procedures, Otorhinolaryngological Surgical,Surgical Procedure, Otorhinolaryngological,Surgical Procedures, Otorhinolaryngological
D019651 Plastic Surgery Procedures Procedures used to reconstruct, restore, or improve defective, damaged, or missing structures. Cosmetic Reconstructive Surgical Procedures,Cosmetic Surgical Procedures,Esthetic Reconstructive Surgical Procedures,Esthetic Surgical Procedures,Plastic Surgical Procedures,Reconstructive Surgical Procedures,Reconstructive Surgical Procedures, Cosmetic,Cosmetic Reconstructive Surgery,Procedure, Reconstructive Surgical,Procedures, Reconstructive Surgical,Reconstructive Surgical Procedure,Reconstructive Surgical Procedures, Esthetic,Surgical Procedure, Reconstructive,Surgical Procedures, Reconstructive,Cosmetic Reconstructive Surgeries,Cosmetic Surgical Procedure,Esthetic Surgical Procedure,Plastic Surgery Procedure,Plastic Surgical Procedure,Procedure, Cosmetic Surgical,Procedure, Esthetic Surgical,Procedure, Plastic Surgery,Procedure, Plastic Surgical,Procedures, Cosmetic Surgical,Procedures, Esthetic Surgical,Procedures, Plastic Surgery,Procedures, Plastic Surgical,Reconstructive Surgeries, Cosmetic,Reconstructive Surgery, Cosmetic,Surgeries, Cosmetic Reconstructive,Surgery Procedure, Plastic,Surgery Procedures, Plastic,Surgery, Cosmetic Reconstructive,Surgical Procedure, Cosmetic,Surgical Procedure, Esthetic,Surgical Procedure, Plastic,Surgical Procedures, Cosmetic,Surgical Procedures, Esthetic,Surgical Procedures, Plastic
D020380 Needs Assessment Systematic identification of a population's needs or the assessment of individuals to determine the proper level of services needed. Assessment of Health Care Needs,Determination of Health Care Needs,Educational Needs Assessment,Assessment of Healthcare Needs,Determination of Healthcare Needs,Assessment, Educational Needs,Needs Assessment, Educational,Needs Assessment, Healthcare,Needs Assessments,Needs Assessments, Educational,Needs Assessments, Healthcare

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