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Inpatient vs. Outpatient Care: What’s the Difference?

Date
December 6, 2024
Image
Two patients: one in a hospital bed, and one at home on the couch with medication on the table in front of her.

When patients undergo treatments, procedures, or checkups, they have the option of receiving health care services in inpatient or outpatient care centers. A key aspect of comparing inpatient vs. outpatient care includes understanding the definition of each.

Inpatient care describes treatments and procedures that require observation of the patient by physicians, clinicians, or other medical professionals over a number of days. Patients stay at inpatient care facilities such as hospitals overnight. Amid the current pandemic, inpatient care remains critical for COVID-19 patients with respiratory issues that require the use of life-saving respirators over many days — even weeks and months.

Outpatient centers are typically used by patients undergoing treatments and medical procedures that do not require overnight stays. The shift away from inpatient services helps ensure that resources are available for those with the most severe symptoms.

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What Is Inpatient Care?

Inpatient care refers to medical services that require a patient to be admitted by a doctor into a hospital or other health care facility so they can stay overnight for medical observation. Inpatient care patients typically have serious conditions or are recovering from life-threatening traumas that require monitoring by physicians or nurses over more than one day.

For a patient to receive inpatient status, a doctor must make the request. However, the process does not merely involve a doctor or hospital signoff. Guidelines published in the Medicare Benefit Policy Manual help health care providers determine which patients should be given inpatient status. According to the guidelines, not every patient who stays more than one day is considered inpatient. Some receive observation status, which, according to Verywell Health, can be more costly than inpatient care services.

When it is not necessary, avoiding inpatient care can result in significant cost savings for the party responsible for paying the cost of care — for example, the patient’s insurance plan. Even so, patients may opt for inpatient services in certain instances despite the costs, such as when they are undergoing substance abuse disorder rehabilitation or managing clinically complex problems such as Alzheimer’s disease. These patients can receive the necessary care in long-term facilities that provide physical, cognitive, and emotional well-being and psychological support.

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Types of Inpatient Care

Types of inpatient care include the following:

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Different Inpatient Care Facilities

Various types of facilities can provide inpatient care. Examples include:

Five types of inpatient care facilities.

Inpatient care is designed to treat conditions that require the patient to stay at least one night in a care-related facility. Several facility types fall under this category, including acute care facilities, rehabilitation centers, addiction treatment facilities, psychiatric hospitals, and long-term care facilities.

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Inpatient Care Resources

These resources provide more details about inpatient care facilities, including inpatient care costs, types of patient care services, and tools for patients and health care practitioners.

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What Is Outpatient Care?

Outpatient care describes any medical procedure or treatment that does not require a patient to stay overnight. When considering inpatient vs. outpatient care, whether or not the patient has an overnight stay is what typically defines the difference between the two, but exceptions exist. For example, an emergency room (ER) visit is generally considered an outpatient service, even if a patient will likely require an overnight stay. If an ER visit results in an extended stay and a doctor formally admits the patient to the hospital, that patient’s status changes to inpatient.

Typically, outpatient care can include physical examinations or one-time and ongoing treatments, such as chemotherapy for cancer patients. When surgeons order lab work before performing surgery, patients can visit labs in outpatient centers to save time and costs. The information obtained in the outpatient care visit is then shared with the surgeon, enabling them to determine if underlying health issues may cause complications during a surgical procedure.

Hospitals typically generate more revenue from inpatient services. However, in recent years, a shift toward outpatient care has been growing. The American Hospital Association reports that the revenue gap between outpatient and inpatient services is closing. A large portion of the revenue generated in health care derives from Medicare patients.

According to data from the Kaiser Family Foundation, the total number of Medicare beneficiaries as of 2018 was close to 60 million people. When it comes to inpatient vs. outpatient care, the distinction is critical to ensuring proper payment of health care services for Medicare patients: Medicare Part A pays for inpatient care, while Medicare Part B pays for outpatient care, such as preventive services.

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Types of Outpatient Care

Outpatient care encompasses everything from patients seeking substance abuse treatment in outpatient rehabilitation centers to athletes undergoing surgical procedures for minor injuries. Additional examples include:

Five examples of outpatient treatments.

Outpatient care is administered without an overnight stay in a facility. Outpatient treatments can include routine physical examinations, blood work, urinalysis, CT scans, and chemotherapy sessions.

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Different Outpatient Care Facilities

Various types of facilities provide outpatient care. For example, a doctor’s office can provide annual physicals, preventive care, and pre-surgery blood work. Additional examples of outpatient care facilities include:

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Outpatient Care Resources

The following resources provide further information on outpatient care.

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Clinic vs. Hospital: What’s the Difference?

Clinics and hospitals offer different kinds of care. Clinics are much smaller than hospitals and do not offer overnight stays. Clinics are ideal for healthy patients who are undergoing routine preventive care such as immunizations, and those seeking a doctor’s opinion for routine ailments.

Hospitals, on the other hand, offer a wide range of medical specialty services, from outpatient services to inpatient care. Typical examples include cardiology, allergy and immunology, sports medicine, vascular surgery, and urology. In an emergency such as a life-threatening injury or an acute illness, individuals can go to a hospital without an appointment. For nonemergency issues, patients generally must schedule an appointment with a primary care provider, who can then refer them to a specialist if necessary. In addition to emergencies and specialist appointments, patients go to hospitals to receive specific medical treatment or undergo surgery.

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The Role of a Nurse Practitioner in Inpatient and Outpatient Care

According to the American Association of Nurse Practitioners, 14.5% of nurse practitioners (NPs) work in hospital outpatient clinics, while 12.1% work at inpatient hospital units. In both inpatient and outpatient care settings, they help ensure optimal care delivery, but their daily functions may vary.

Nurse practitioners can serve as both primary and specialty care providers. Their responsibilities can extend to include administration, teaching, and research. Specializations in inpatient settings include the following:

Nurse practitioner specializations in outpatient settings include the following:

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Prepare for the Role of Nurse Practitioner

Whether in inpatient or outpatient facilities, nurse practitioners serve a critical role. Medical innovations, the increased digitization of health care, and advancements in care have made it possible for nurse practitioners to take leading roles in patient care. In many states, they can serve as primary caregivers. An advanced degree such as a Doctor of Nursing Practice can help nurses advance their careers and take on leadership roles in various health care settings.

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