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How To Decide Between Inpatient versus Outpatient Procedures

July 9, 2019

Deciding between inpatient and outpatient procedures can sometimes be hard. If you’re like most people, you prefer your own bed. Your own food. Your own clothes. You want to be at home.

It’s that desire — along with drastic improvements in technology—that have allowed more and more procedures to be done on an outpatient basis. According to statistics from the Agency for Healthcare Research and Quality (AHRQ), in 2014, more than 17 million hospital visits (inpatient and outpatient) included surgical procedures. More than half (57.8 percent) occurred in a hospital-owned outpatient surgery setting, and the remaining (42.2 percent) were inpatient. And according to the Centers for Disease Control and Prevention, the number of outpatient surgery visits in the United States account for nearly two-thirds of all surgery visits.

So what is the difference between inpatient and outpatient procedures?

Inpatient versus Outpatient Procedures: The Differences

The most obvious difference is that inpatient care is done in a hospital where you will spend the night. Outpatient care may be done in a hospital or an ambulatory care center and the patient goes home after the procedure.

Common inpatient procedures include:

Common outpatient surgeries include:

In general, outpatient procedures are less invasive than inpatient procedures.

As clear-cut as that may seem, the definition can get murky, especially when it comes to health insurance or Medicare.

Insurance May Affect Your Decision

For the purposes of healthcare coverage, you must be formally admitted into a hospital for a service to be considered inpatient. That means a doctor must write a note to give the order to admit you.

For example, if you experienced chest pains and went to the hospital to have them checked out, you might stay the night for “medical observation,” but that does not make you an inpatient.

If you spend time in the hospital but are never formally admitted, you may be ineligible for coverage on any follow-up time that may be needed at a skilled nursing facility.

According to a recent report from Hospital Case Management, many hospitals are also confused about the issue. In fact, the report calls the distinction between inpatient and outpatient classification as “clear as mud.”

So where does that leave you, the patient?

It’s prudent to educate yourself as much as you can on the issue and also to stay informed because we all know how quickly the world of healthcare can change. Determining the difference between outpatient surgical procedures and inpatient surgery options that include overnight stays can be very helpful. But it’s also up to caseworkers at the hospital admissions office to correctly classify your status as a patient — and to keep you informed as to what that status is and what it means for you.

Deciding between inpatient and outpatient care can be difficult, but we’re prepared to guide you through any hospital stay. Contact us today if you have any questions about an upcoming medical procedure.

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