Importance Of Ambulatory Care
Ambulatory care consists of health care services that warranted an overnight stay in the hospital. Today, ambulatory care encompasses an expanding and broad array of services rather than just visits to private physicians’ offices and hospital outpatient clinics. Several factors have influenced the shift from inpatient hospitalization to ambulatory services such as, technological advancements, financial mandates, cost considerations, conveniently located facilities, and the entry of physicians into the business of outpatient services.
New diagnostic and medical procedures and technological advancements have allowed procedures that in the past required hospitalization to be performed on an outpatient basis. The surgical procedures that in the
past have required hospitalization can now be performed on a same-day ambulatory basis. Financial mandates have also influenced the shift from inpatient to outpatient services. Starting in the 1980’s prospective hospital reimbursement replaced retrospective payment on a national scale through Medicare’s initiation of the diagnosis- related group payment system. This new system provided financial incentives intended to decrease the duration of inpatient stays and to increase service delivery efficiency. Hospitals responded by reducing the number of inpatient procedures to outpatient delivery. Another factor that contributed to the shift in services was cost considerations. With the change in payment systems, health care purchasers were pressured to control costs. Since ambulatory care costs less than inpatient care, one way to contain costs was to reduce the number of inpatient services and increasing the number of outpatient services. An increased consumer demand for conveniently located facilities also influenced the shift. Facilities and services located on hospital campuses were often not easily accessible due to the congestion of the hospital. The last factor that influenced the shift from inpatient to outpatient services was the entry of physicians into the business of diagnostic, surgical, and treatment services that were previously only offered in the hospital setting. This reduced costs for physicians, addressed consumer demand for convenient locations, and increased profitability.
New diagnostic and medical procedures and technological advancements have allowed procedures that in the past required hospitalization to be performed on an outpatient basis. The surgical procedures that in the
past have required hospitalization can now be performed on a same-day ambulatory basis. Financial mandates have also influenced the shift from inpatient to outpatient services. Starting in the 1980’s prospective hospital reimbursement replaced retrospective payment on a national scale through Medicare’s initiation of the diagnosis- related group payment system. This new system provided financial incentives intended to decrease the duration of inpatient stays and to increase service delivery efficiency. Hospitals responded by reducing the number of inpatient procedures to outpatient delivery. Another factor that contributed to the shift in services was cost considerations. With the change in payment systems, health care purchasers were pressured to control costs. Since ambulatory care costs less than inpatient care, one way to contain costs was to reduce the number of inpatient services and increasing the number of outpatient services. An increased consumer demand for conveniently located facilities also influenced the shift. Facilities and services located on hospital campuses were often not easily accessible due to the congestion of the hospital. The last factor that influenced the shift from inpatient to outpatient services was the entry of physicians into the business of diagnostic, surgical, and treatment services that were previously only offered in the hospital setting. This reduced costs for physicians, addressed consumer demand for convenient locations, and increased profitability.