Brianna Wallace
ThursdayNov 23 at 9:27pm
Outpatient care is described as an individual (patient) who receives healthcare services (such as surgery) on an outpatient basis, meaning they do not stay overnight in a hospital or inpatient facility. Many insurance companies have identified a list of tests and procedures (including surgery) that will not be covered (paid for) unless they are performed on an outpatient basis. The term outpatient is also used synonymously with ambulatory to describe healthcare facilities where procedures are performed (Anderson, 2022).
Reimbursement, technology, utilization control, and social factors are key changes that contribute to the shifting of balance between inpatient and outpatient services. With the changes being implemented, and incentives for reimbursement of outpatient care, hospitals have created outpatient services to help with the decline in income from inpatients. The development of new diagnostic and treatment procedures and less invasive surgical methods has enabled services in outpatient settings that previously required inpatient hospital stays (Shi & Singh, 2019). Payers are trying to minimize hospital stays so closely monitoring patients while in the hospital is increased to try to minimize hospital stays. Patients generally prefer receiving health care in home and community-based settings. Indeed, most people do not want to be institutionalized unless absolutely necessary (Shi & Singh, 2019).
Continuity of care is a defining attribute of primary care and a core element of the Institute of Medicine’s definition of primary care. Continuity is generally recognized to have three dimensions: continuity in information, in management, and in the physician-patient relationship. Relationship continuity is the ongoing interaction of a patient with one physician, which results in increased knowledge of patient preferences, better communication, and improved trust (Sharma et al., 2009). Outpatient healthcare delivery has been shaped in many ways but one of the main foundations is primary care. Services beyond primary health care have become an integral part of outpatient services. As specialist services increase in supply and use, specialist physicians have become more integrated into the primary care system; however, improvement is still needed to ensure seamless coordination of care between specialists and primary care providers (Shi & Singh, 2019). Primary care can be described as basic or routine care. Primary care should be the point of entry into a health services system (Starfield, 1992, p. vii), that is, the first contact that a patient makes with the health care delivery system (Shi & Singh, 2019). One of the main functions of primary care is to orchestrate health care services between the patient and the health care system. Coordination of an individual’s total health care needs ensures continuity and comprehensiveness. These goals of primary care are best achieved when the patient and the provider have established a close relationship over time (Shi & Singh, 2019).
Coordination of an individual’s total healthcare needs ensures continuity and comprehensiveness. These goals of primary care are best achieved when the patient and the provider have established a close relationship over time (Shi & Singh, 2019). Primary care is considered as essential care and in an ideal healthcare delivery environment primary care is the base.
Outpatient services are important in hospital settings and help with revenue and should be utilized. Outpatient services now transcend basic and routine primary care services, as many general medical and surgical interventions are provided in ambulatory care settings. In response to changing economic incentives in the health care delivery system, numerous types of ambulatory services have emerged, and a variety of settings for the delivery of services have developed. In most settings, patients visit delivery sites to receive services. In other cases, services are brought to the patients (Shi & Singh, 2019). Administrators need to consider how important outpatient services are when understanding why it is an important element of their business strategy, outpatient services are necessary for effective patient-centered care. Philippians 2:4 reads. “Not looking to your own interests but each of you to the interests of the others.” The care of the patients should be the main priority.
References
Anderson, S. (2022, July 7). What does outpatient mean? | healthinsurance.org. healthinsurance.org. https://www.healthinsurance.org/glossary/outpatient/
Philippians 2:4 (NIV). (n.d.). Bible Gateway. https://www.biblegateway.com/passage/?search=Philippians%202%3A4&version=NIV
Sharma, G., Fletcher, K. E., Zhang, D., Kuo, Y. F., & Freeman, J. L. (2009). Continuity of outpatient and inpatient care by primary care physicians for hospitalized older adults. JAMA, 301(16), 1671. https://doi.org/10.1001/jama.2009.517
Shi, L., & Singh, D. A. (2019). Essentials of the U.S. health care system. https://openlibrary.org/books/OL22552128M/Essentials_of_the_U.S._health_care_system