Question

• We learned that inpatient stays are declining while outpatient care is steadily increasing. We are seeing this same trend with long-term care. Seniors are increasingly staying in their homes and communities longer. Why do you think this is? What are some of the key influences that have impacted this shift? Avoid creating a list. Rather, pick a couple and talk about these thoughtfully using your assigned materials and any outside credible sources you wish to bring in to support your statements. You might talk about socioeconomic or political influences. You might also consider how healthcare professionals have influenced this trend. Whatever you decide, talk about the “why.”

Answer 1

A declining trend in pattern of patient’s need of hospitalization and average duration of hospital stay is observed across the globe. It is a positive sign to be welcomed because longer a patient stays in the hospital, the greater will be his risk for healthcare-acquired infection (HAI), which brings additional cost to the system. In addition, hospitals beds will be free to accommodate new patients so it ensures better availability of resources rather than competition over them. Hospitals will be better able to manage their assets and efficiency will be enhanced. Costs arising out of hospital acquired infections will be also reduced.

Data also shows that outpatient care is the fastest growing segment in the market, and this shift is attributed to advancements in medical technologies, bio technology, information technology, financial services and a shift in patient preferences.

There are many factors for this trend. Few significant factors among those are-

· Medical advancement and latest technologies

In recent decades advancement in field of health care and latest technologies, is the single most important factor which had played a very significant role in reducing length of hospitalization or has taken it to a new level.

Think of a patient undergoing cataract surgery and is in hospital for 3 days, bandage itself to be removed on next day of surgery and compare it with latest techniques where patient can be at home in few hours, that also without any dressing, simply with a protective glass and can resume his activities of daily living. Just consider it on a bigger scale, number of cataract surgeries dine in a year and how much burden on health care relieved from this approach.

Advancement in surgical techniques, laparoscopic surgeries, minimally invasive surgeries, laser surgeries and so on have totally changed the scenario. They made is possible to treat diseases on outpatient basis. Now even patients with hip surgeries, joint replacement, coronary artery bypass is also having a very shorted hospital stay.

Emerging technologies in the field of diagnosis had also made it possible to arrive at definitive diagnosis at the earliest, which has reduced the waiting time for results of diagnostic tests and unnecessary delay in treatment due to lack of diagnosis is no longer a reality.

Newer generation antibiotics have also results in faster recovery, easy to combat infections and reduces chances of transmission.

Another greatest factor that has influenced hospitalization is immunization. Now due to expanded programmes of immunization and availability of vaccines hospitalization due to such disease has declined and so is hospitalization arising out of them.

Think of telemedicine, why one would prefer to be in hospital when he can get expert opinion from the comfort of his home. Mobile applications, various apps, video conferencing all has made recovery accessibility more convenient- a top advantage of outpatient care.

· Consumer/ patient preferences

Outpatient care has its advantages. Lower costs associated with outpatient care is the biggest advantage. Outpatient care is not subject to hospital room charges or other related fees, making outpatient substantially less expensive than inpatient care. Many patients prefer the in-and-out nature of outpatient surgeries and the ability to spend the recovery period with their loved ones in the comfort of their own homes.

· Better availability of health care facilities

Another reason for reduced hospitalization is better availability and accessibility of health care facilities. In earlier times, even still today in remote areas patients used to prefer to stay in hospital for few more days rather than coming back after few days for follow up, like for suture removal. Now that is no longer the case.

In nut shell, medical and technological advancements, patient preferences, and financial incentives are tilting the balance in favor of outpatient hospital services. Financial incentives have likely played a role as well. Various health plans and program, policies support providing services in lower-cost care settings, including outpatient facilities.