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

Abstract 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.