What Is the Difference Between Inpatient and Outpatient Care?
If you are experiencing symptoms of a medical problem, should you go to the hospital or visit a small doctor’s office? The answer may depend on the severity of your condition. If it is not a life-threatening emergency, you should usually contact a doctor’s office first, in which case you are an outpatient.
You may think that the difference between inpatient and outpatient care is that the former takes place in a hospital, while the latter occurs in a separate clinic. However, that is not strictly true. Treatment at a hospital requires at least one overnight stay to truly be considered inpatient. Therefore, if you go to the emergency room but are discharged the next day, that is considered an outpatient hospital stay.
What Types of Providers Will You Encounter?
During an inpatient stay at a hospital, which may last one night or many, you are likely to interact with a large group of providers, including doctors, physician assistants, nurses and nurse practitioners, physical therapists, lab technicians, and pharmacists.
Depending on the nature of your medical problem, you may also encounter all or some of these providers during the course of outpatient care. However, you may need to travel to see them because they are often not all housed in the same facility.
Many doctors who run small private practices are general practitioners or family physicians who see many types of patients and treat a little bit of everything. However, there are some specialists who have taken the necessary steps to start a business and open clinics dealing specifically with orthopedics, nephrology, physical therapy, same-day surgery, etc.
What Are the Costs Associated With Each Type of Care?
Your medical expenses depend largely on the type of treatment you receive, but there are some differences depending on whether you are an inpatient or an outpatient and whether or not you are on Medicare. If you are on Medicare, inpatient hospital services are covered by Part A and outpatient services are covered by Part B. This usually only becomes an issue if you have an overnight stay in the hospital under observation status, because Medicare will not cover that at all.
If you are not on Medicare, matters are a little more straightforward. The hospital will charge facility-based fees in addition to the costs of any medical services you receive. These fees are not charged for outpatient services, meaning that you only pay for the care you get, e.g., examinations and tests.
If your condition requires inpatient treatment at a hospital, you have no choice but to pay the associated fees. However, if you require a service, such as a diagnostic test, that can be performed on either an inpatient or outpatient basis, it is better to choose outpatient so you do not have to pay the associated fees.
What Types of Services Are Typically Provided in Each Setting?
There can be some overlap between inpatient and outpatient care. Outpatient care usually involves treatment and tests that are more routine, such as wellness checks and physical examinations, same-day emergent care (e.g., stitches), specialist consultations, diagnostics (e.g., mammograms or colonoscopies), minor surgeries, lab tests, and imaging studies such as X-rays or MRIs. Inpatient care is required for serious injuries, complex surgeries, some types of rehabilitation, and delivering a baby.
When Should You Go To a Hospital Rather Than a Doctor’s Office?
If you have symptoms of a potentially life-threatening medical emergency, you should go to the emergency room at the hospital. These include seizures, uncontrolled bleeding, shortness of breath, chest pain lasting more than two minutes, stroke symptoms, and major broken bones. If you are not sure about the seriousness of your symptoms, call your doctor’s office first. A general practitioner can refer you to the hospital if necessary.
Do not go to the emergency room if your symptoms are definitely not life-threatening. This makes it harder for ER personnel to provide care to the people who really need it. You will probably need to wait a long time to be seen, and the cost may wind up being higher than it would have been if you sought outpatient care in the first place.
