[Presence and future of emergency medicine in Germany].

Health care policy has changed duties and responsibilities of hospitals in Germany. The transition zone of in- and outpatient care has been recognized as a critical gateway for the success of hospitals, subsequently leading to the appreciation of the value of professionalized emergency departments. Currently, hospital-based emergency medicine in Germany is organized in a very heterogeneous manner. Due to the key function of emergency departments for the medical and economic success of hospitals, professional expertise in clinical emergency medicine has to be strengthened: We discuss possible models of hospital-based emergency care and present first data that professionalisation of hospital-based emergency medicine in Germany improves treatment quality and outcome of patients presenting with chest-pain or community-acquired pneumonia to the emergency department. Furthermore, those strategies are accompanied with the improvement of economic characteristics. Summing up, professionalisation of hospital-based emergency medicine in Germany is urgently needed and may improve medical and economic success of hospital-based patient care.