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DB 5

Tina Kandle

COLLAPSE

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Discussion Board Week 5

Define outpatient care. What are several key changes that have been instrumental in shifting the balance between inpatient and outpatient services? Why is it important for hospital administrators to regard outpatient care as a key component of their overall business strategy?

            “Outpatient services refers to any healthcare services that do not require an overnight stay in a healthcare institution” (Shi et al., 2019, p 155).  It used to be that outpatient care was just primary care.  But with advances in medical technology, outpatient care now encompasses a variety of services.  The main goal is to improve overall health by focusing on access to primary care and outpatient care while moving away from the high utilization of costly specialty and inpatient care (Fortney et al., 2005).

            According to Shi et al., reimbursements, medical technology, and utilization control have been key players in the shift from inpatient to outpatient utilization (2019, p, 157).  Outpatient treatments cost less, technology provides less invasive procedures and minimization of hospital stays are due to utilization control   American policymakers and stakeholders are beginning to focus on transforming the U.S. healthcare system into a more value-seeking system (Sorenson et al., 2013).  The ACA has invested in comparative effectiveness research to promote value in Medicare payment and delivery systems.  “The proverbs of Solomon, son of David, king of Israel:  To know wisdom and instruction, to understand words of insight, to receive instruction in wise dealing, in righteousness, justice, and equity; to give prudence to the simple, knowledge and discretion to the youth-Let the wise hear and increase in learning, and the one who understands obtain guidance,…”(OpenBible, English Standard Version, 2001, Proverbs 1:1-33). 

            Hospitals administrators should pay attention to outpatient services and primary care because these services are more cost-effective.  Studies show that states with more primary care providers have higher quality care and lower costs (Baicker, 2004).  A study of approximately 70,000 patients who participated in the Medical Expenditure Panel Survey shows that patients with primary care receive high-value care (Levine et al., 2019).  Primary care in conjunction with outpatient services increases patient experience, patient health and reduces medical waste, thereby reducing medical spending.             

References:

Baicker  K, Chandra  A. (2004)  Medicare spending, the physician workforce, and beneficiaries’ quality of care.  Health Aff (Millwood). W4-184-97. doi:10.1377/hlthaff.W4.184

Fortney, J. C., Steffick, D. E., Burgess, J. F., Maciejewski, M. L., & Petersen, L. A. (2005). Are primary care services a substitute or complement for specialty and inpatient services? Health Services Research, 40(5p1), 1422-1442.  https://doi.org/10.1111/j.1475-6773.2005.00424.x

Levine, D. M., Landon, B. E., & Linder, J. A. (2019). Quality and experience of outpatient care in the united states for adults with or without primary care. JAMA Internal Medicine, 179(3), 363-372. https://doi.org/10.1001/jamainternmed.2018.6716

Open Bible. (2001). English Standard Version.  https://www.openbible.info/topics/

Shi, L., Singh, D. A., & Shi, L. (2019). Essentials of the U.S. health care system (Fifth; 5 ed.). Jones & Bartlett Learning.

Sorenson, C., Drummond, M., & Burns, L. R. (2013). Evolving reimbursement and pricing policies for devices in Europe and the United States should encourage greater value. Health Affairs, 32(4), 788-96. http://ezproxy.liberty.edu/login?qurl=https%3A%2F%2Fwww.proquest.com%2Fscholarly-journals%2Fevolving-reimbursement-pricing-policies-devices%2Fdocview%2F1337185762%2Fse-2%3Faccountid%3D12085

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Outpatient care

Discussion Board Week 5

Lynn Bulloch

COLLAPSE

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Did you know class that alot of what is now managed in outpatient care, used to require hospitalization. Did you know that patients on our hospital floors today used to be in ICU and that the patients in our ICUs today would not be here a few years ago....this is the progression of the acuity of care we have seen with healthcare's evolution.  And this trend is expected to continue as we continue to see medical advances and our population live longer.

Some key perspectives that you should take away from this study, while these are not the only 'right' answers,

What are several key changes that have been instrumental in shifting the balance between inpatient and outpatient services? The number 1 driver--the money, patient care goes where the money goes. When payment changes, the care follows.

Population health initiatives also are driving care into the home. As we look at how we help populations of patients manage chronic diseases, it all starts with patient and self-care in their home.

Why is it important for hospital administrators to regard outpatient care as a key component of their overall business strategy?

Because it is an important part of the healthcare continuum. Increasingly under new payment provisions, hospitals are not just paid for the care they render while the patient is in the hospital, but they are paid for patient outcomes, regardless of where care is rendered- home, under home health, physician office, outpatient setting, or in the hospital. All are part of the continuum of care for population health.

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