What is Inpatient vs. Outpatient Care?

The difference between inpatient and outpatient care is the duration of a stay at a medical facility due to surgery, procedure, or treatment. Inpatient facilities require overnight hospitalization so the patient can remain under the supervision of a healthcare provider, while outpatient facilities do not require patients to stay overnight. 

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Difference Between Inpatient vs Outpatient Care

Inpatient care often requires patients that have recently undergone a surgery, procedure, or treatment to stay overnight in a medical facility to be closely monitored by a healthcare provider. The length of stay depends on the type of procedure, and the costs can vary as well. Typically, the longer stay, the more expensive the bill. 

Outpatient care does not require patients to remain under the supervision of a healthcare provider after a procedure or treatment. Patients are able to leave once the procedure is complete, or once they are able to resume normal activities when anesthesia has worn off. Receiving care at an outpatient facility is often less expensive due to fewer medical supplies used during recovery. 

The Cost of Outpatient vs. Inpatient Care

The cost of the care can depend largely on the type of treatment one is receiving. Oftentimes, inpatient care is more expensive due to more supplies, personnel, and maintenance to upkeep the facility and maintain your safety. 

An emergency room (ER) visit is often considered an outpatient service, despite hospitals being classified as inpatient facilities. There are thousands of treatments and services to be had at outpatient and inpatient facilities, and some procedures can be done at either inpatient or outpatient facilities such as endoscopies and ultrasounds. 

Outpatient Treatment Cost

You are typically able to receive outpatient care when your condition is not severe and there are no complications. Below are a few examples of the costs for outpatient treatments and services when paying without insurance.

Inpatient Treatment Cost

When you get a more complex medical procedure or have a severe illness, you may require inpatient care.  The mean length of stay at a hospital for an uninsured patient as of 2016 was about 4.1 days with an average cost of $9,300. Below are some of the most common inpatient surgeries and their national average costs without insurance:

Types of Outpatient Care Facilities

Outpatient services often include procedures that do not require extensive monitoring such as wellness and prevention treatments, diagnostic tests, chemotherapy treatments, and rehabilitative services. These services are offered in many settings such as: 

• Medical group practices
• Outpatient clinics at hospitals
• Surgery centers
• Imaging centers
• Cardiac catheterization centers
• Mental or behavioral health centers
• Lab centers
• Gastrointestinal centers
• Medical equipment rental facilities
• Physical therapy centers
• Chemotherapy and radiation therapy centers

Types of Inpatient Care Facilities

Patients undergoing inpatient care typically require more intensive care to treat more serious and potentially life-threatening conditions. A hospital stay can last between just a few days to a few weeks. Rehabilitative services, surgeries, childbirth, and serious illnesses may require inpatient care. Types of inpatient care facilities include:

• Acute care facilities
• Rehabilitation centers
• Addiction treatment facilities
• Psychiatric hospitals
• Long-term care facilities

Outpatient vs. Inpatient Care Frequently Asked Questions (FAQs)

Below we have answered commonly asked questions regarding treatment at inpatient and outpatient facilities. 

How should I choose an outpatient facility?

In order to pick the best outpatient facility, you can review the reputation and the quality of the center. You may also want to consider the center’s ability to manage and access emergency equipment in the event of a complication during your surgery. If you have other underlying health conditions, you may be at risk for emergency care, so the connection to a major hospital could be an important aspect to consider. 

Some additional considerations for choosing a facility include: 

• Level of follow-up care
• The center’s location in relation to your home
• Communication channels offered by the facility post-treatment
• Your insurance coverage and your ability to pay for the cost of care

When should you choose inpatient or outpatient facilities?

The type of procedure or illness you have will help determine what type of facility is best for you. If you are going for a routine exam, or minor diagnostic procedure, oftentimes choosing an outpatient facility will be cheaper. But if you require more invasive surgery, your doctor will likely want you to be monitored overnight to ensure your safety and assist with recovery.

As previously mentioned, outpatient services can be a more cost-effective alternative to inpatient care. Outpatient service centers also specialize in one type of treatment or procedure and often have the most advanced equipment and techniques. In addition, with outpatient care, you can recover from a procedure in the comfort of your own home.

How can I save money on inpatient and outpatient care without insurance?

There are many ways that you can save money on inpatient and outpatient care without health insurance. Below are some ways to help manage the costs of healthcare. 

• Catastrophic health insurance is available to those under 30 years of age. This type of insurance often has a high deductible and helps you avoid very high bills during a catastrophic event where you would require inpatient care.
• Hospital indemnity insurance is another option when planning for major surgery to help reduce the burden of high costs associated with inpatient care.
• Care membership plans, such as Mira can help offset the high out-of-pocket costs for preventative care, urgent care, labs, and prescriptions.

Is inpatient and outpatient care covered by health insurance?

Hospital coverage often depends on the type of insurance plan that you have. For example, if you have Medicare, outpatient care and physician-related services occurring at inpatient facilities are covered under Part B. Additional hospital services such as rooms and meals would be covered under Part A of Medicare. 

For other insurance plans, outpatient care such as standard preventative check-ups or exams would be covered under the Affordable Care Act, while other procedures might have to be deemed medically necessary for the costs to be covered once you have met your deductible. You may also require an additional insurance policy in order to have a vision and dental services covered for outpatient care and surgeries. The amount your insurance provider will cover for a hospital stay will depend on your health insurance policy, but additional health insurance plans such as indemnity insurance can help cover the costs of inpatient treatment.

Bottom Line

Inpatient and outpatient facilities treat conditions on the basis of the expected duration, recovery process, and intensity of the treatment. Some treatments can also take place at either inpatient or outpatient facilities, such as rehabilitative services. In general, inpatient care is more expensive than outpatient care. 

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