Health Insurance 101: Reviewing Inpatient Vs Outpatient Hospitalization
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Jan 03 2024
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Have you ever heard of the word Nosocomephobia? We bet you’ve experienced this sensation without knowing it. Nosocomephobia is simply an intense and overwhelming fear of visiting the hospital. If given a chance to recover from an illness at home or in the hospital, wouldn’t you rather choose your home? But some ailments are best treated at the hospital. This is why terms like inpatient and outpatient hospitalization exist in the health insurance vocabulary. So, what is the meaning of inpatient and outpatient hospitalization and how do the two differ? Let’s find out together.
What is Inpatient Hospitalization?
When you are unwell and need to stay in the hospital for one or more nights, your hospital stay is classified as inpatient hospitalization. You could be admitted for various reasons – an illness or accident that leads to continuous monitoring, complex treatments, or surgical procedures. As such, the doctors may need to keep an eye on you until you recover from the ailment/surgery.
Typically, inpatient hospitalization entails the following incidents and associated costs:
- Room Charges: You need to rent out a hospital room for the duration of your stay.
- Nursing Care: Professional nurses may be tasked with monitoring your vitals.
- Doctor’s Fees: Doctors may operate on you and visit you frequently.
- Surgical Procedures: You may need to undergo surgeries which may add to the costs.
- Diagnostic Tests: You may also need to undergo several tests, X-rays, etc.
- Medications: You may be prescribed medicines during your hospital stay.
- Meals: The hospital also takes care of your meals.
Inpatient care essentially allows doctors to immediately respond in case of any medical emergency and ensure you receive immediate and correct treatment.
What is Outpatient Hospitalization?
Certain medical treatments, including surgeries do not warrant an overnight stay. It could be a simple procedure conducted at hospital, that does not require constant monitoring or complex treatments. Essentially, you can receive medical attention at the hospital/clinic and go home the same day.
Outpatient hospitalization covers a wide range of services like:
- Consultations: You may need to consult healthcare professionals, including specialists.
- Diagnostic Tests: Doctors may ask you to undergo some tests like blood work and X-rays.
- Minor Surgeries: You may need a minor surgical procedure without having to stay overnight.
- Rehabilitation Services: These include costs for therapies or sessions to aid recovery.
- Medications: Your doctor may prescribe medication for a few days.
- Follow-up Appointments: You may be asked to visit again for post-treatment consultations.
Outpatient care offers the advantage of convenience. It allows you to maintain your daily routine while taking care of your medical needs.
| Did You Know? Inpatient hospitalization covers you against the cost of both, pre-planned surgeries as well as an emergency procedures. |
Inpatient vs Outpatient Hospitalization – The Differences
The main difference between inpatient and outpatient prescription is the level of care you receive and the amount of time you need to spend in the hospital:
| Inpatient Vs Outpatient Hospitalization | |
| It involves a minimum stay of one night at the hospital |
You do not need to stay at the hospital even for a single night |
| Inpatient care is more inclusive and rigorous |
Outpatient care is less rigorous |
| It involves continuous monitoring and a higher level of medical attention |
Outpatient care may not necessitate intense medical attention or monitoring |
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Doctors need you to stay hospitalised so that they can observe your vitals and responses to treatments |
Since the treatment and procedures are typically simple, close observation may not be required |
Inpatient vs Outpatient Care – Comparing Surgeries, Medical Care, Costs and More
To understand the differences between inpatient and outpatient care more clearly, consider the following examples:
| Inpatient vs Outpatient Hospitalization | |
| Major surgeries like bypass surgery, open-heart surgery, etc., are examples of inpatient procedures | Minor procedures like cataract surgery, tonsilitis surgery, etc., are examples of outpatient procedures |
| It involves rehabilitation with the goal to make the patient self-sufficient without having to rely on others for help. | Since the procedures are not complicated, the patient would be capable of self-care soon after the surgery. |
| Involves the monitoring of vitals like oxygen levels, BP, heart rate, etc., via machines. |
Health can be monitored via routine tests like blood test, X-rays, etc., a few days after the surgery |
| Expenses like room rent, ICU charges, food costs, medicines, injections, doctor visits, etc. | Charges for a few hours of occupying a hospital room/bed are significantly lower. |
| Did You Know? Treatments like chemotherapy, minor surgeries, stitches for wounds, kidney dialysis, etc., are covered under outpatient hospitalization. |
Inpatient vs. Outpatient – The Role of Physicians and Medical Caregivers
A major point of difference between inpatient and outpatient care involves the role of healthcare professionals you interact with during the treatment course:
| Inpatient And Outpatient Services | |
| A team of medical experts works together to provide complete care. |
The medical team is more streamlined and focused on specific aspects of your health |
| The inpatient team includes specialists, surgeons, nurses, anaesthetists, dieticians etc. |
A big team of healthcare professionals may not be needed. A primary physician and a nurse may suffice. |
| You would typically interact with the same team of experts and assistants for a well-rounded treatment. | You may not always be attended by the same doctor. A resident doctor may attend to your needs. |
Outpatient or Inpatient Care – What Should you Choose?
Typically, you do not get to choose whether you need inpatient or inpatient cares. Your doctor assesses your condition to determine the recommended treatment course based on the following factors:
- The severity of your medical condition
- Whether you need constant monitoring and intensive treatments.
- The recovery period after undergoing a procedure.
- Whether your health insurance covers either treatment costs.
- Whether your health insurance permits both modes of treatment.
| Did You Know? You can leverage the cashless claim benefit and seek treatment at a network hospital when you opt for inpatient hospitalization. |
Enjoy Inpatient and Outpatient Hospitalization Coverage with Manipal Cigna Health Insurance Plans
At Manipal Cigna Health Insurance, we strive to offer all-encompassing coverage under our health insurance plans. Every policy we offer is designed to cover inpatient and outpatient treatments, as well as domiciliary hospitalization costs. You can visit our website to check out the extensive range of health insurance policies we offer. What’s more you can buy your policies and file your health insurance claims online, directly through our website.
Safeguard your health and your finances – Invest in Manipal Cigna Health Insurance Plans
FAQs
Can I decide if I require inpatient or outpatient hospitalization?
Whether you need to opt for inpatient vs outpatient hospitalization depends on your various factors like your medical condition, how severely ill you are, and whether you can afford the treatment costs. It is thus best to let your doctor decide whether you need outpatient or inpatient hospitalization.
Do inpatient and outpatient services have any similarities?
Yes, both inpatient and outpatient services aim to address your healthcare needs through trained medical professionals. They involve consultations, diagnostic tests, and treatments. Additionally, both may include follow-up care to ensure inclusive, effective medical support.
Does outpatient care include minor surgeries?
Yes, minor surgeries are often performed on an outpatient basis, wherein you do not need overnight hospitalization. It could entail anything as simple as putting sutures to an 8-hour chemotherapy session to a routine colonoscopy.
Are inpatient and outpatient hospitalization covered under health insurance policies?
Yes, almost all health insurance plans cover both types of hospitalization. Comprehensive coverage typically includes a variety of medical services, from overnight stays in the hospital (inpatient) to outpatient procedures, consultations, and diagnostic tests. You must review your insurance policy to understand the specific coverage provided.
Can doctors recommend the transfer of a patient from outpatient to inpatient care in case of emergencies?
Yes, doctors may recommend a patient to transfer from outpatient to inpatient care if complications arise. If a patient does not show improvement from the recommended outpatient treatment courses, and if their health takes a turn for the worse, doctors may recommend inpatient hospitalization.