<p>Beyond participating in patient care, university hospitals in Germany are additionally engaged in conducting research and providing academic teaching. The transition from inpatient to outpatient care, initiated by the German federal government, poses relevant challenges for university hospitals, as they must fulfill their core tasks despite economic pressures. The financial difficulties are exacerbated by rising costs, a&#xa0;shortage of specialized staff, and complex billing systems, while infrastructure is often insufficient. Shifting to outpatient care is intended to save costs, improve care and relieve burden on staff. However, remuneration for outpatient services is often insufficient to cover the resulting costs. Medical innovations and quality of care can be impaired by inadequate funding. Outpatient procedures are already well established internationally, for example in the USA, and can sometimes achieve better results. In Germany, postoperative care and the selection of suitable patients still need improvement. In order to successfully implement outpatient care, measures such as the development of effective decision-making tools, integrated outpatient surgery centers, separate reimbursement of material costs and implants, as well as seamless postoperative follow-up care are proposed. The training of young physicians must consequently be adapted so that outpatient procedures can also be comprehensively taught. A&#xa0;shift from inpatient to outpatient treatment can only be effective if it is designed in a&#xa0;medically, qualitatively, and economically sensible way. A&#xa0;measure that focuses purely on cost-saving without providing appropriate remuneration jeopardizes patient care, research, and scientific work at university hospitals.</p>