Inpatient Vs Outpatient Care
The Nitty Gritty Details By Insurance Experts
Inpatient vs outpatient care. What does it mean, what do they cover and why the hell should it matter to you! Well, don’t stress. I’m here to help break it down.
These are terms you’ll see a lot, and they’re pretty important when picking the right insurance for you. In fact, they are very important.
Whether you’re travelling the world or setting up shop in a new country, knowing your ins and outs of inpatient and outpatient care (pardon the pun) is very necessary.
Also, I’ve got you a more detailed guide on what is inpatient care here. And another more detailed guide for what is outpatient care here.
Give them a read if you want to learn specifics on each! Let’s get into it.
Quick summary: Inpatient care involves staying in a hospital bed overnight or longer for treatment, such as surgeries or intensive care. For example, if you’re hospitalised for a complex fracture, inpatient care covers your surgery and hospital stay. Outpatient care is treatment received without an overnight stay, like check-ups or minor procedures. An example is managing diabetes with regular doctor visits and medication. Medical insurance typically covers both inpatient and outpatient services, while travel insurance often only covers major medical emergencies, not the comprehensive range of inpatient and outpatient benefits.
What Is Inpatient Care?
Well, what exactly is inpatient care? It’s a very common question we get asked here most days by our clients. Well, here’s my simple breakdown of exactly what inpatient care is and when it’s required or needed.
Inpatient care is treatment requiring hospital admission and overnight stay
Inpatient care is designed for situations where a medical condition is serious enough to require hospitalisation. When you’re admitted as an inpatient, the level of medical attention and monitoring is significantly higher compared to outpatient services.
So simply put, inpatient care is when you are admitted to hospital overnight. This type of care is essential for critical conditions that require constant medical supervision, complex procedures, or recovery time that can only be provided by staying in a hospital overnight.
Specialised units such as intensive care are covered under inpatient benefits as well. These units are equipped with advanced medical technology and staffed by healthcare professionals with specialised training to handle critical conditions.
Example:
Inpatient care is needed when a person undergoes major surgery, such as a heart bypass, and must stay in the hospital for multiple nights for recovery and close monitoring.
Inpatient care definition:
Inpatient care involves an insured person staying in a hospital bed for one or more nights to receive treatment. This means the patient stays overnight or for several days in a hospital to receive necessary medical services, which could include surgeries, advanced diagnostics, or close monitoring by healthcare professionals. It’s a key component of medical insurance coverage and is typically more comprehensive and costly than outpatient services.
What Is Outpatient care?
And of course, we have outpatient care which goes hand in hand with inpatient care, but differ in many different ways. Again, we also get asked a lot by our customers on what is outpatient care. So here’s a simple explanation on what it is and when it’s required.
Outpatient care is medical treatment without hospital admission
Outpatient care is catering to less severe medical issues that can be managed without the need for hospital admission. This type of care is integral for the treatment of conditions that require medical expertise but are not life-threatening or do not necessitate round-the-clock monitoring.
General consultations with doctors form the backbone of outpatient services. These are routine visits where you discuss health concerns, receive advice, and obtain treatment plans for various medical issues.
Outpatient care is designed to be convenient and accessible, ensuring that you can receive the necessary medical attention with minimal disruption to your life.
So, in simple terms, outpatient care is anything that isn’t critical and won’t require you to be admitted to a hospital overnight.
Example:
Outpatient care is required for treating a common cold or minor cuts and bruises at a general practitioner’s clinic.
Outpatient care definition:
Outpatient care is treatment received at a medical facility without admission to a hospital bed or an overnight stay. Patients receive care and return home the same day. It’s generally less costly than inpatient care and is often covered by medical insurance policies, subject to the terms of the policy.
What Is Covered By Inpatient Vs Outpatient Care?
So, although inpatient and outpatient care are so closely aligned, they do differ in what they both actually cover. As you would expect, inpatient is for when you are inside the hospital and outpatient is for when you just return home, so each will cover different things.
Here’s my expert breakdown of exactly what is covered in outpatient care versus inpatient care.
What Inpatient Care Covers...
Generally, inpatient care covers the medical costs associated with staying in a hospital overnight and the care you will receive. This can be anything from hospital stays, intensive care units, surgeries, professional fees and/or medications.
It also includes specific treatments like kidney dialysis, cancer care, and organ transplants, as well as parental accommodation when necessary. Those are just some examples that we have come across with our clients.
Here’s a full list of everything that is included in inpatient care.
List of everything inpatient care covers
- Room and Board: Hospital accommodation and meals provided. For example, the cost of your hospital room and the meals you receive during your stay.
- Intensive Care: Specialised care in an intensive care unit for serious conditions. For instance, if you’re critically ill and need constant monitoring.
- Surgeon’s Fees: Costs for surgical procedures performed by a surgeon. An example is the fee for a surgeon to perform a knee replacement.
- Anaesthetist Fees: Fees for the provision of anaesthesia during surgery. This could be the cost for an anaesthetist to administer anaesthesia for a surgical procedure.
- Professional Fees: Charges from physicians, specialists, radiologists, pathologists, and physiotherapists. For example, the cost of a consultation with a cardiologist.
- Theatre Fees: Costs for the use of the operating theatre, including equipment and medications. This includes the charges for the room where your surgery takes place and the medical supplies used.
- Rehabilitation: Services to aid recovery after surgery or illness, such as physiotherapy sessions to regain mobility after an operation.
- Kidney Dialysis: Treatment for kidney failure, which might include the cost of dialysis sessions.
- Oncology Cover: Treatment for cancer, including chemotherapy and radiotherapy. For example, the cost of a course of chemotherapy.
- Emergency Room Treatment: Immediate care provided in emergencies, such as treatment for a broken bone after an accident.
- Organ Transplant: Procedures for organ replacement, including the surgery and aftercare. An example is the cost associated with a liver transplant operation.
- Parental Accommodation: An added bed for a parent to stay with their child during hospital admission. For instance, if your child is hospitalised, this would cover the cost for you to stay in the same room.
Types of services included in inpatient care
Here’s a general list of services that are included in inpatient care, but not included in outpatient care.
- Emergency surgeries
- Diagnostic tests and imaging
- Prescribed in-hospital medications
- Nursing care
- Specialist consultations
- Post-operative care and monitoring
- Physiotherapy and rehabilitation services (within the hospital)
- Parental accommodation for children’s hospital stays
Inpatient care covers things like intensive care, surgeries & accommodation
When living or travelling abroad, the importance of inpatient benefits is magnified. Healthcare costs can vary dramatically from one country to another, and without comprehensive coverage, individuals might find themselves facing exorbitant bills.
Inpatient benefits ensure that the costs for room and board in a hospital, surgeries, intensive care, and any other necessary treatments that require hospital admission are taken care of.
For things like surgeries, inpatient benefits cover the operating theatre costs, the surgeons’ fees, anaesthesia, and any post-operative care needed while you remain in the hospital.
The peace of mind you will get from being covered for inpatient benefits cannot be overstated. Knowing that you are covered for the full spectrum of inpatient services allows you to focus on your recovery rather than worrying about financial implications.
This is particularly reassuring for expatriates and travellers who may not be familiar with the healthcare system or cost structure of the country they are in when an emergency strikes.
What Outpatient Care Covers...
So, generally outpatient care covers medical treatment and consultations at clinics or hospitals without an overnight stay. This includes services like GP visits, minor surgical procedures, and immediate treatment for injuries like cuts and sprains. It also includes the cost of medication prescribed during these visits.
But, here’s a list of everything that outpatient care will cover, that is not covered until inpatient care.
List of everything outpatient care covers
- GP Consultation Fees: Charges for appointments with a general practitioner for routine health issues. For example, visiting a GP for a persistent cough or flu symptoms.
- Specialist Consultation Fees: Costs for seeing a medical specialist for their expert opinion and treatment plans. An example is consulting a dermatologist for a skin condition.
- Prescribed Medication: Medicines that a doctor prescribes during an outpatient visit, such as antibiotics for an infection.
- Outpatient Surgical Procedures: Minor surgeries that can be completed without an overnight hospital stay, like the removal of a cyst.
- Oncology Cover: Outpatient treatments for cancer, including consultations and chemotherapy sessions.
- Diagnostic Tests: Medical tests, including blood tests and imaging like X-rays or MRIs, to help diagnose health issues.
- Physiotherapy: Treatment sessions with a physiotherapist to aid recovery from musculoskeletal conditions or post-surgery rehabilitation.
- Pre-Hospitalisation Tests: Diagnostic tests conducted before a planned hospital admission to ensure safe and effective treatment, such as blood work before surgery.
- Post-Hospitalisation Treatment: Follow-up care and consultations after being discharged from the hospital to monitor recovery, like wound checks or removal of stitches.
Types of services included in outpatient care
And here is also a list of services that come under outpatient care which are not included within inpatient care:
- Surgical services
- Nursing care
- Diagnostic imaging
- Laboratory services
- Rehabilitation services, including physiotherapy
- Mental health support
- Intensive care unit (ICU) services
- Maternity care
- Paediatric services
- Anaesthetic services
Outpatient care covers things like consultations, follow ups & specialist procedures
Outpatient benefits cater to the more routine aspects of healthcare. These include things such as managing ongoing conditions, preventive care, different types of therapy and any minor medical surgeries.
These benefits are essential for maintaining overall health and managing recovery from an inpatient hospital stay. They are also important for everyday living. If you require some minor healthcare, the last thing you want is an extra bill.
Outpatient care makes sure you’re covered by this and now left out of budget. Preventive care is another critical element covered by outpatient benefits. This includes health screenings, immunisations, and annual check-ups that are fundamental in detecting health issues early on.
In essence, outpatient benefits ensure that your healthcare needs are comprehensively met without the need for hospital admission, supporting your health proactively and reactively.
When Should You Choose Between Inpatient Vs Outpatient care?
Well, as a general rule of thumb you should choose inpatient care for serious conditions requiring hospital stays, surgeries, or intensive monitoring.
And you should generally choose outpatient care for routine treatments, minor procedures, or consultations that don’t necessitate overnight hospitalisation.
Now, it’s important to remember your medical needs and the severity of your condition will dictate the appropriate level of care. If you are in need of an emergency, then it’s obvious you will need inpatient care.
Anyway, here’s a list of examples and more details into when you should choose either inpatient or outpatient care.
When you should choose inpatient care
You should choose inpatient care over outpatient care when the medical condition is severe or complex. This can include situations that are requiring hospital admission, extensive monitoring, surgery, or specialised treatment that cannot be provided on an outpatient basis.
Don’t forget, inpatient care ensures that patients receive continuous medical supervision, which is crucial for conditions that could rapidly change or deteriorate. So from this, choose inpatient care when you have something serious happening.
Examples
- Intensive care after a severe accident.
- Major surgeries that require postoperative hospitalisation.
- Conditions needing continuous monitoring, like certain heart issues.
- Serious infections that necessitate intravenous medications and close observation.
- Complex medical treatments that can only be administered in a hospital setting.
When you should choose outpatient care
Well, outpatient care is often more cost-effective and less disruptive to daily life, making it a suitable option for managing many health issues. Generally, you would choose outpatient care over inpatient care when the medical treatments or procedures are routine, less complex, and do not require an overnight hospital stay.
If you know that you are not going to require an emergency, and instead can go and visit your doctor to see if there are any issues then I’d recommend choosing outpatient care over inpatient care here. Here’s some examples anyway.
Examples
- Routine check-ups with a GP or specialist.
- Minor surgical procedures, such as mole removal or minor wound stitching.
- Diagnostic tests like blood work or X-rays that don’t require hospitalisation.
- Follow-up appointments after inpatient treatment to monitor recovery.
- Treatment for common illnesses or non-severe conditions that can be managed with prescribed medication.
Outpatient Vs Inpatient Comparison Table
Aspect | Inpatient Care | Outpatient Care |
Location | Hospital ward or room | Clinic or day surgery centre |
Duration | Overnight, several days, or longer | Same-day return home |
Types of Procedures | Major surgeries, intensive care | Minor procedures, routine tests |
Monitoring | Continuous by hospital staff | During the procedure or test only |
Cost | Generally higher due to extensive services | Lower due to less resource use |
Recovery | Hospital-based recovery | Recovery at home |
Example | Undergoing heart surgery | Getting a flu shot or blood test |
What To Expect From Inpatient Vs Outpatient Care
So, in general if you require inpatient care, you can expect a hospital stay with 24/7 medical support. This will include things like; room and board, intensive monitoring, and comprehensive treatment for serious conditions. All of your recovery processes and all necessary services will occur within the hospital. This is where you will spend a fair amount of your time.
On the other hand, if you require outpatient care then anticipate same-day medical services for less severe conditions. This can be for things like consultations, minor procedures, and diagnostic tests. You’ll return home the same day without an overnight hospital stay. Outpatient care is more about convenience and managing ongoing health needs efficiently.
Inpatient care might take longer and cost more, whereas outpatient care can usually be done within a day or two so you can return home. Those are the main differences, but I’m ready to get more specific.
Here’s a breakdown of what you can expect for inpatient versus outpatient care.
What can you expect from inpatient care?
So, here’s a little bit more details for those of you who have never experienced inpatient care. Most of you would have at some point in your life, but some maybe not. Inpatient care is designed for conditions that require close medical supervision, which outpatient settings cannot provide.
When you’re admitted as an inpatient, the hospital becomes your temporary residence where you receive all your medical care. This environment is equipped with the necessary medical equipment and staff to address your health needs at any hour.
You can expect to be under the care of a team of healthcare professionals pretty much all of the time. This will include doctors, nurses, and specialists, who are all working together to provide a coordinated treatment plan for you.
The goal is to stabilise your condition and promote recovery in a setting where help is immediately available if your condition changes or complications arise.
This is different to outpatient care where you will likely visit a clinic or hospital for a few hours then return home.
What can you expect from outpatient care?
Now, outpatient care is a different story. Typically, you can expect to receive medical services that don’t require an overnight hospital stay. This will include things like consultations, minor procedures, and diagnostic tests. You’ll usually visit a clinic or hospital, receive treatment, and then return home the same day.
Outpatient care is the management of less severe health issues that can be treated without the need for intensive hospital resources. It’s a convenient option for routine medical care, follow-up appointments, and treatments that can be scheduled and completed quickly.
It’s certainly less stressful than inpatient care. And you know that it’s not as severe as well so you don’t have to worry as much. Overall, outpatient care is much less disruptive to your daily life.
It allows for the efficient management of health issues with the flexibility of living at home. You’ll interact with healthcare professionals during your appointment or procedure, but you won’t have the continuous monitoring that inpatient care provides.
Both Inpatient & Outpatient Are Covered In Medical Insurance
A comprehensive medical insurance policy should ideally include both inpatient and outpatient benefits. This ensures a full spectrum of medical care is accessible when needed, from major surgeries to routine check-ups.
For instance, if you were to suffer a complex fracture while hiking, requiring immediate hospitalisation, surgery, and a multi-day hospital stay, the inpatient portion of your insurance would cover these costs.
Then, once discharged, you might need several follow-up visits with an orthopaedic specialist to ensure proper healing and rehabilitation. You may also require regular physiotherapy sessions to regain full mobility.
These services fall under outpatient care, and a comprehensive medical insurance policy would cover these visits and treatments, preventing you from incurring significant out-of-pocket expenses.
Having both inpatient and outpatient coverage means that whether you need a one-time hospital stay for a sudden illness or injury, or ongoing care for a chronic condition, you are fully equipped for it all.
Which Is More Important, Inpatient Or Outpatient?
While the nature of inpatient and outpatient care differs, they are equally important in a healthcare journey. Outpatient care can prevent conditions from worsening and thus avoid the need for inpatient care, while inpatient care is vital for more serious health issues.
Outpatient care is the first line of defence in the healthcare system, addressing minor ailments and managing chronic conditions through services such as regular check-ups, medication management, and minor medical procedures.
On the other hand, inpatient care is indispensable when it comes to more acute medical situations that necessitate advanced treatment within a hospital.
Conditions like a heart attack or a severe infection often require immediate hospitalisation, specialised treatment, and continuous monitoring, all of which are provided under inpatient care.
Both types of care are integral to a well-functioning medical healthcare system.
Inpatient & Outpatient Care Is Usually Not Included In Travel Insurance
Travel insurance typically focuses on covering major medical emergencies that occur while you’re travelling. However, it often lacks the comprehensive inpatient and outpatient benefits that a medical insurance policy provides.
This means that routine doctor’s visits, follow-up care, and minor procedures are not usually covered. For instance, if you have an existing medical condition that requires monitoring, the consultations, tests, and treatments would not be covered by your travel insurance.
The lack of comprehensive inpatient and outpatient coverage in travel insurance means that you could face significant out-of-pocket expenses for treatments that are not classified as emergencies.
While travel insurance provides essential coverage for emergencies, it is not a substitute for medical insurance. It’s important you understand these limitations. We’ve got a blog covering this topic in more detail here.
Make sure you are covered by a substantial medical policy with a high plan limit
Securing a medical policy with a high plan limit is essential, particularly for international expats and nomads (we have awesome nomad insurance plans as well).
Getting medical attention in different countries with their own healthcare cost structures can pose a significant financial risk.
A comprehensive medical policy with a high plan limit ensures that you are covered for a wide range of medical services, from routine outpatient care to more complex inpatient treatments.
We aim to go for 1m in excess and up to 2m in our larger, fully comp plans. Don’t settle for anything less than this. This can be especially important in countries where medical costs are notoriously high, or where you may not be eligible for local healthcare services.
Why does that matter? Well, it allows you to focus on your work and life without the added stress of healthcare-related uncertainties.
Don’t forget, try to avoid medical insurance plans that are cheap but make you pay a deductible. You can find out what a deductible is here.
Conclusion
So then. Take the time to review the benefits offered by an insurance company carefully. Your health is your most valuable asset, especially when you’re far from home.
Investing in a policy that provides thorough coverage for both inpatient and outpatient care is not just a smart choice—it’s essential for your wellbeing as you travel or work abroad.
A final quick recap: Both types of care serve vital, yet distinct roles in your overall healthcare provision. Inpatient care is your safety net for serious medical events requiring hospital stays, while outpatient care supports your day-to-day health needs without the need for hospital admission.
Share your thoughts in the comments below! Ask any questions or share any stories. We’d love to hear everything.
