What is the difference between Inpatient & Outpatient Hospitalisation?
What is the difference between Inpatient & Outpatient Hospitalisation?
When it comes to seeking medical care, you may have come across terms like “inpatient hospitalisation” and “outpatient hospitalisation” and wondered what’s the difference between them. Well, you are not the only one. These terms can be a bit confusing, especially if you’re not well acquainted with the healthcare system. Understanding the distinction between inpatient and outpatient hospitalisation is crucial as it determines the level of medical attention, duration of stay, and associated costs. Let’s try and learn the key differences between them, explore the types of medical services offered in each setting, and whether the best health insurance covers them. Knowing about these will help you better understand which option might be appropriate for your specific needs.
What is inpatient hospitalisation?
When a medical treatment or procedure requires that you have to be admitted to a hospital for a minimum of 24 hours, it is called inpatient hospitalisation. Simply put, in inpatient hospitalisation, you have to stay overnight in the hospital or for an extended period for close observation and monitoring by doctors. Usually, inpatient hospitalisation is pre-planned for any surgery or treatment, such as cancer surgeries, C-section deliveries, bypass surgeries, etc. It can also be due to a medical emergency such as a stroke, heart attack, or traumatic injury. Any hospitalisation of less than 24 hours is not considered inpatient. Inpatient hospitalisation expenses are usually covered in health insurance plans
.Types of inpatient care
There are 2 types of inpatient care:
1. Serious medical conditions which need in-depth observation and constant monitoring, such as respiratory disorders, strokes, heart attacks, brain damage, coma, accidental injuries, etc.
2. Complicated surgeries, such as brain surgery, bypass surgery, and organ transplantation, which require long-term observation by doctors.
What is outpatient hospitalisation?
When you get treated for a medical condition without being admitted to the hospital, it is called outpatient hospitalisation. Outpatient visits typically include doctor consultations, diagnostic tests, patient rehabilitation, follow-up visits, etc., which are done in the Outpatient Department (OPD) of the hospital, clinics, or diagnostic centres. Outpatient treatment expenses are usually not covered in the basic health insurance policy. You have to buy health insurance plans with outpatient hospitalisation coverage or add OPD coverage to your base health insurance by paying an additional premium.
Types of outpatient medical care
Some of the common outpatient treatments which do not require hospitalisation are listed below:
• Diagnostic tests such as X-rays, CT scans, MRI, ECG, and EEG
• Blood tests
• Chemotherapy for treating cancers
• Dialysis
• Urine analysis to check for kidney problems, bladder infections, etc
• Dental procedures such as root canal treatment, scaling, polishing, tooth extraction, implants, etc
Difference between inpatient hospitalisation and outpatient hospitalisation
Let’s take a look at how inpatient and outpatient hospitalisations are different from each other:
| Categories | Inpatient Hospitalisation | Outpatient Hospitalisation |
| Meaning | The patient has to be formally admitted to the hospital for at least 24 hours |
The patient doesn’t require formal hospitalisation and gets treated by a doctor in the OPD |
| Type of treatments | Serious illnesses, complex surgeries, accidental injuries, etc | Diagnostic tests such as CT scans, MRI, blood tests, X-rays, medical screenings, etc |
| Cost | Higher than OPD treatments | Considerably lesser than inpatient care |
| Healthcare professionals | Specialised surgeons, physicians, physical therapists, etc | Physicians, nurses, therapists, etc |
| Health insurance coverage | Health insurance covers the expenses incurred up to the sum insured | Outpatient visits are not covered unless specified in the policy. You have to opt for OPD add-on coverage by paying an additional premium |
FAQs
1. How to know if I need inpatient or outpatient care?
This depends on the severity of your health condition and the type of medical treatment and care you require. If the treatment is for major surgeries or severe illnesses that need close monitoring and observation by doctors, it would be inpatient hospitalisation. You have to be formally admitted to the hospital. On the other hand, minor procedures, medical screenings, and dental treatments that do not require 24-hour hospitalisation can be treated as outpatient care.
2. Which is expensive – inpatient or outpatient care?
Inpatient hospitalisation is expensive. The reason is hospitalisation expenses include room rent, diagnostic tests, doctor consultations, medicines, operation theatre charges (if you have to undergo any surgery), ICU charges, injections, IV fluids, etc. But you need not worry about the expenses because your health insurance policy will take care of the costs incurred up to the sum insured.
3. Is outpatient hospitalisation covered by health insurance?
Most health insurance providers do not provide OPD coverage; one has to opt for OPD add-on coverage by paying an extra premium. But some health insurance companies cover OPD in the basic health insurance plan. So, while buying the best health insurance, check if the plan covers OPD expenses.
Conclusion
Knowing the difference between inpatient and outpatient hospitalisation will help you buy the best health insurance plan based on your healthcare needs. Most inpatient hospitalisation expenses are covered by health insurance up to the sum insured. But outpatient visits are covered depending on your health insurance plans, and most health insurers do not provide OPD coverage in your base healthcare plan. Depending on your requirements, you have to get it added to your health insurance plan.
Disclaimer : The above information is for illustrative purpose only. For more details, please refer to policy wordings and prospectus before concluding the sales
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