What is the Difference Between Inpatient and Outpatient Settings and Services?
Outpatient service, also called ambulatory care, is a way of treatment that does not require overnight patient stays in a medical facility. Traditionally, primary care is the basis of outpatient care, but its capabilities expand as the population demand various services (Shi & Singh, 2019). Nowadays, outpatient services include care centers and laboratories and imply different directions – from mental health to clinical tests and blood banks (“Types of healthcare,” n.d.). Outpatient care patients come to the hospital on their own to receive the necessary diagnostic and therapeutic services. In some cases, patients arrive by ambulance, or medical representatives arrive to people to provide services.
Inpatient services and care, in turn, require patients’ presence overnight. Such services may be necessary in cases when clients of medical institutions require the supervision of specialists. For example, patients unable to provide for their own needs, having a severe illness, or undergoing a complex operation should remain inpatient. Many hospitals have departments providing care, both ambulatory and inpatient. As the effectiveness of hospitals increases, treatment shifts from inpatient settings to outpatient (“Types of healthcare,” n.d.). Various departments require staff and equipment, which is influenced by funding, management style, and other aspects.
Affordable Care Act (ACA) significantly impacted the delivery of healthcare services in the United States. According to Crowley and Bornstein (2019), the number of people receiving inpatient and outpatient care has increased thanks to the ACA, and outpatient and preventive services have improved. Considering the ambulatory settings, the law significantly focused on primary care creating additional training programs and offering new incentives and benefits to providers (Shi & Singh, 2019). Moreover, the ACA eliminated the cost of preventive measures to shift the focus to disease prevention. However, it will take much time to attract more employees and achieve new goals due to a lack of resources (Shi & Singh, 2019). In the inpatient settings, ACA has a contradictory impact, as an increased number of patients generates revenue and simultaneously grows bad debt loads (Shi & Singh, 2019). As a result, the healthcare system requires subsequent improvements to make services available and not damaging for providers.
Explain How the Fee-For-Service Practice of Medicine Led to Uncontrolled Utilization
The fee-for-service practice assumes that medical providers will independently assign a price for their services, and patients are free to choose which specialist to contact. As a result, the efforts of medical representatives guided by this practice were aimed at creating an impression of quality, which moved the competition between specialists (Shi & Singh, 2019). Since the providers’ popularity was based on their image, the reality of the demand for their services remained dubious. Moreover, freedom in setting prices forced doctors to put very high prices, even for small items.
In the circumstances of pricing by providers, insurance companies could not affect the cost of medical services. Subsequently, they covered only those costs that were considered rational. Moreover, insurers could increase the cost of their services, which did not give them an incentive to control prices. Other concerns included failure to cover preventive services and policies to cover hospitalization. In the latter case, insurance significantly covered expensive hospitalization and was beneficial for doctors and hospitals, leading to measure abuse.
Changes made to the medical system by ACA have significant advantages over the fee-for-service practice. The latter measure constantly increased spending on health care and made it inaccessible to the population. Moreover, fee-for-service is likely the cause of geographical differences in care, which is often evidence of improper health system’s work (Sood et al., 2021). The introduction of ACA helped reduce costs while maintaining health care quality (Sood et al., 2021). As a result, geographical differences in service delivery have decreased, indicating greater integrity.
Long-Term Care Settings and Services Must Be Individualized, Integrated, and Coordinated. Elaborate on this Statement, Pointing Out Why These Elements are Essential in the Delivery of LTC
The clients of LTC are the older generation and require many medical services, which means that such institutions should not be separated from the health system but integrated into it. LTC customers often have chronic diseases, and as a result, some restrictions prevent them from taking care of themselves. It is also worth noting that people who require settlement in the LTC have different health conditions and backgrounds – cultural, religious, occupational, and other aspects (Shi & Singh, 2019). Employees need to collect accessible information and develop an individualized plan to make care more effective. Moreover, all individual needs should be addressed in a coordinated manner. LTC should combine its activities with non-LTC services, like the work of dentists or laboratories. As a result, such efforts will improve the clients’ well-being and their condition.
Despite the importance of LTC and the need for their services by many people, only a tiny part of the older generation can get them. The inaccessibility of LTC was considered a national crisis earlier, as most people have limited resources (CBS Sunday Morning, 2014). The living circumstances did not allow the older generation and their caregivers to seek professional help, and the need to do everything on their own only reduces resources. The ACA influenced the work of the LTC and made their services more accessible to the American population. According to a study by Van Houtven et al. (2020), a significant part of the population that had an unmet need for LTC services could get this opportunity after the introduction of ACA. As a result, more low-income people can get the care they need.
References
CBS Sunday Morning. (2014). Aging in America: Crisis in long-term care [Video]. YouTube. Web.
Crowley, R. A. & Bornstein, S. S. (2019). Improving the patient protection and Affordable Care Act’s insurance coverage provisions: A position paper from the American College of Physicians.Annal of Internal Medicine, 170(9), 651-653. Web.
Shi, L. & Singh, D. A. (2019). Delivering healthcare in America: A systems approach (7th ed.). Jones & Bartlett Learning.
Sood, N., Yang, Z., Huckfeldt, P., Escarce, J., Popescu, I., & Nuckols, T. (2021). Geographic variation in Medicare fee-for-service health care expenditures before and after the passage of the Affordable Care Act.JAMA Health Forum, 2(12), 1-13. Web.
Types of healthcare professionals and settings. (n.d.). Lumen Learning. Web.
Van Houtven, C. H., McGarry, B. E., Jutkowitz, E., & Grabowski, D. C. (2020). Association of Medicaid expansion under the Patient Protection and Affordable Care Act with use of long-term care.JAMA Network Open, 3(10), 1-10. Web.