Draft a meaningful reply to another students discussion board post. Here is the post you
are replying to:
Outpatient care is a health care service that does not require an overnight stay in a
hospital and can be performed in a variety of locations such as private clinics, hospitals,
at home, mobile facilities or outpatient facilities. (Shi & Singh, 2019, pg.155) Many people
outside of the health care community may not see or know a difference between
outpatient and hospital services, but there are several ways that help us to differentiate
the services and locations, as well as explain to a patient the difference and why we see
more outpatient services now more than ever. One of the first and most obvious reasons
for the shift to an outpatient health care setting is cost and reimbursement. There are
incentives for having an outpatient setting for the healthcare facility and we have seen
over the past 20-25 year where hospitals have created separate outpatient centers to
help to decrease cost and increase reimbursement. (Shi & Singh, 2019, pg. 158) One
example I can share is from my experience is a reimbursement with an OB/GYN
procedure. In the hospital this procedure is reimbursed $300.00 to the physician and in
an outpatient setting it is reimbursed $2,400.00. The overall cost to care for the patient is
less in the outpatient center, therefore the reimbursement to the physician is more, yet
still the overall cost to the patient and to operate the facility is less.
Another reason for the shift to an outpatient setting is the use of new technology,
specifically diagnostic equipment and new procedure techniques that do not require an
overnight stay in a hospital. (Shi & Singh, 2019, pg. 158) Procedures that were
traditionally done in an inpatient hospital setting such as a unicompartmental knee
arthroplasty can now be done in an outpatient setting due to updated technology and
outpatient protocols, and studies even show that patient do not have increased anxiety
due to this change in care model. (Hoorntje, Boeve & van Geenen, 2017) Patient
centered care is still the primary focus even when care setting is shifted. This study by
Hoorntje, Boeve & van Geenen (2017) helped show that not all new protocols have
patients feeling at ease, despite new technology and fast track protocols. As health care
administrators we have to work with physicians to research procedures, understand risks
involved and make sure the change is worth the cost.
Utilization control factors are also in place, where insurance companies can tell a patient
where they would prefer them to go for care or flat out reject to pay a claim, leaving the
patient responsible for the cost. (Shi & Singh, 2019, pg. 158) Many hospitals care for
inpatient and outpatient patients from one testing site, which can prove to be a challenge
and can compromise care. (Murray et al., 2017) Murray et al., (2017) discuss the need
for separate outpatient centers in order to best meet the needs of the patients and to truly
distinguish in patient an outpatient services. A company I worked for regularly had patient
who would call an outpatient imaging center and say they were sent there by their insurer
because the cost we preferred over other centers. This is an example of one reason why
the shift has occurred to outpatient health care delivery.
Outpatient services also help with continuity of care for patients, which ultimately help
their overall health and can reduce inpatient visits to a hospital. One example that is
extremely relevant in the United States is the tracking and management of congestive
heart failure (CHF). Cardiologists are tasked with seeing patients within 48 hours of
discharge in hopes of reducing re-admission to the hospital in many of my cardiology
clinics I oversee. From there, a primary care visit should occur within 7-14 days of
discharge and then another cardiology visit after 14 days to help manage the condition
and to provide continuous coordinated care for the patient. This coordination of care also
ties into what hospital administrators need to keep focused on when it comes to
outpatient services. Outpatient services and hospital care need to be connected for
patient care purposes, for cost containment, quality scores and for patient satisfaction. As
a hospital administrator, keeping a pulse on all of these aspects of care will be beneficial
for both inpatient and outpatient settings.
The Bible reminds us in 2 Corinthians 9:10, “For God is the one who provides seed for
the farmer and then bread to eat. In the same way, he will provide and increase your
resources and then produce a great harvest of generosity in you.” (2 Corinthians 9:10,
NIT) What this verse means to me is that we need to be good stewards of what we are
given. If we have a better option for our patients overall care we to choose that, because
it is the right thing to do. Outpatient settings for health care are beneficial for all parties
involved and it is important for us as health care administrators to see these benefits and
use our gifts and resources wisely.
References
Hoorntje, A., Koenraadt, K. L., M., Boevé, M.,G., van Geenen, R. C., & , I. (2017).
Outpatient unicompartmental knee arthroplasty: Who is afraid of outpatient surgery?
Knee Surgery, Sports Traumatology, Arthroscopy, 25(3), 759-766.
doi:http://dx.doi.org.ezproxy.liberty.edu/10.1007/s001...
Murray, T. E., Halligan, J. J., & Lee, M. J. (2017). Inefficiency, dignity and patient
experience: is it time for separate outpatient diagnostics? The British Journal of
Radiology, 90(1080), 20170574. https://doi.org/10.1259/bjr.20170574
Shi, L., & Singh, D. A. (2019). Essentials of the U.S. health care system — with access
(5th ed.). Burlington, MA: Jones & Bartlett Learning
Running head: OUTPATIENT CARE RESPONSE 1
Outpatient Care Response
Name
Institution Affiliation
Date
OUTPATIENT CARE RESPONSE 2
Outpatient Care Response
I agree with you that outpatient services do not require an overnight stay in the hospital.
According to Caffery, Farjian, and Smith (2016), the purpose of the outpatient facility is the
consultation with health specialists or nurse practitioners. That is because patients whose illnesses
do not require a bed in the hospital engage in face-to-face communication with the health specialist,
where the patient explains the symptoms. Outpatient services involve diagnosis and treatment,
which can be provided without additional bedside care. Therefore, after the patient is assessed, and
all information is captured, the nurse can perform diagnostic tests, prescribe treatment, and release
the patient on the same day.
Outpatient and inpatient health care is very different in terms of their intended purpose. I
agree with you that cost and reimbursement are the main factors that facilitated the introduction of
outpatient services in the healthcare sector. According to Hunter et al. (2017), most Americans
faced challenges paying for medical bills in hospitals. This brought the need for strategies that
could be used to make sure that patients have access to affordable healthcare services. The study
performed by Hunter et al. (2017), revealed that the outpatient clinic is a better place for physicians
and patients to discuss the methods for reducing out-of-pocket costs. Therefore, the issue of health
care cost has been partly addressed by outpatient facilities. Outpatient clinics also created a model
for increasing reimbursement in the healthcare sector. As described by Zhang, Wang, Qian, & Ni
(2014), reimbursement has to be increased when it comes to outpatient services because such
clinics need additional equipment and personnel to provide the care. Therefore, you were right to
say that cost reduction and increased reimbursement are associated with outpatient facilities. It is
because a patient can access quality healthcare services in outpatient clinics while paying the little
money as possible.
OUTPATIENT CARE RESPONSE 3
I agree with you that the idea of outpatient setting was inspired by new technologies, which
include technological advancements in diagnostic equipment and procedures. For example,
patients do not require to be in hospitals all the time for the nurses to keep track of their health
status. That is, with the use of electronic health records, it is possible to keep track of patients'
health using historical health data (Shi & Singh, 2019). Also, some traditional therapies that could
take days to complete have become easier to perform with new technological health equipment.
Besides, outpatient clinics are growing dramatically in terms of technology. I think you have heard
about telehealth, which is now one of the new trends in the healthcare sector. With telehealth,
people will be able to access outpatient services at the comfort of their homes and go to hospitals
or outpatient clinics only when it is very necessary.
Moreover, it is correct that performing inpatient and outpatient services in the same setting
may pose challenges or even comprise quality health care. I read an article that explained that
outpatient services are not expensive compared to inpatient care. Also, outpatient care is suitable
for patients with low chances of complications, and those who do not require hospital monitoring
(Crawford, Li, Sprague, & Bhandari, 2015). This is a huge difference between inpatient and
outpatient care for them to be performed under the same setting. It is because there might be a
problem when balancing the resources needed for the two sets of healthcare services. Therefore, I
would also say that outpatient services are essential for the continuity of care for the patients. It is
because many patients can be handled in outpatient clinics since there is no issue of allocating
limited hospital beds. Importantly, outpatient services are considered safer than inpatient services
(Crawford et al., 2015), probably because patients are involved in their care.
OUTPATIENT CARE RESPONSE 4
References
Caffery, L. J., Farjian, M., & Smith, A. C. (2016). Telehealth interventions for reducing waiting
lists and waiting times for specialist outpatient services: A scoping review. Journal of
telemedicine and telecare, 22(8), 504-512.
Hunter, W. G., Zhang, C. Z., Hesson, A., Davis, J. K., Kirby, C., Williamson, L. D., ... & Ubel, P.
A. (2016). What strategies do physicians and patients discuss to reduce out-of-pocket
costs? Analysis of cost-saving strategies in 1,755 outpatient clinic visits. Medical Decision
Making, 36(7), 900-910.
Zhang, L., Wang, Z., Qian, D., & Ni, J. (2014). Effects of changes in health insurance
reimbursement level on outpatient service utilization of rural diabetics: evidence from
Jiangsu Province, China. BMC health services research, 14(1), 185.
Shi, L., & Singh, D. A. (2019). Essentials of the U.S. health care system — with access (5th ed.).
Burlington, MA: Jones & Bartlett Learning
Crawford, D. C., Li, C. S., Sprague, S., & Bhandari, M. (2015). Clinical and cost implications of
inpatient versus outpatient orthopedic surgeries: a systematic review of the published
literature. Orthopedic reviews, 7(4).
Outpatient Care Response
I. I agree with you that outpatient services do not require an overnight stay in the hospital.
II. Outpatient and inpatient health care is very different in terms of their intended purpose.
III. I agree with you that the idea of outpatient setting was inspired by new technologies, which
include technological advancements in diagnostic equipment and procedures.
IV. Moreover, it is correct that performing inpatient and outpatient services in the same setting
may pose challenges or even comprise quality health care
