Inpatient vs outpatient care in the UK
What’s the difference between inpatient vs outpatient (UK)?
The main difference between inpatient and outpatient treatment is in the way you attend for care. As an inpatient, you can expect to stay in the hospital overnight. Outpatient treatment is delivered in a series of appointments where you can go home in between. We’ll explain more in the following sections.
What is an inpatient?
When you’re treated as an inpatient, you’ll need to stay overnight in a hospital while you receive treatment.
That could be because you’ve had major surgery and must be closely monitored to ensure you’re recovering well. You may also need rehabilitation treatment such as physiotherapy to get you back on your feet.
In some cases, good patient care means that the hospital needs to check you have appropriate follow-up support to help you with daily tasks before you can go home.
You could also need inpatient treatment because there are different elements involved in your care, and it’s more efficient for you to have a hospital stay so that you can receive coordinated medical treatment from a range of specialists.
You may also receive day patient care if appropriate.
What is a day-patient?
Day-patient care is somewhere between inpatient and outpatient care. It’s possible to have surgery as a day case. These are typically lower-risk operations where you need to have some time staying in the hospital but will usually be able to go home on the same day.
Cancer treatment is also sometimes delivered in a day unit, particularly chemotherapy, where you may need to stay in the hospital for several hours.
Examples of treatments typically provided while you’re an inpatient:
Major surgeries include hip or knee replacement operations or heart surgery.Rehabilitation following surgery, such as physiotherapy.Care following a major accident.Treatment for serious illnesses which need ongoing monitoring, including some cancer care.Hospital treatment for severe burns.Mental health support for serious psychiatric conditions or drug and alcohol addiction.
While these treatments need inpatient care, you’re also likely to need outpatient care as well. This could be before inpatient treatment or afterwards to monitor your progress.
What is an outpatient?
Outpatient care (sometimes called ambulatory care) is provided when you don’t need to stay overnight in a hospital to receive treatment. Instead, you’ll be able to go to the hospital for your outpatient appointment and then go home afterwards.
What kind of conditions are suitable for outpatient care?
Outpatient care can be offered for less severe conditions that still need regular treatment over a period of time without hospital admission. This could include musculoskeletal conditions that can be improved with regular physiotherapy.
You might also be treated as an outpatient for more serious chronic conditions that need to be monitored, for example, diabetes, asthma, cystic fibrosis or angina.
You might also need outpatient care in the run-up to inpatient treatment to prepare you for surgery or to assess the type of treatment you might need.
You’ll also likely be offered outpatient care after a stay in hospital to ensure that you’re recovering well and to allow your doctors to plan any further treatment you might need.
Examples of treatments typically provided while you’re an outpatient:
Preliminary appointments with a consultant before you’ve received a diagnosis.Diagnostic tests include x-rays, MRI, PET or CAT scans, and blood tests.Routine check-ups.Physiotherapy.Radiotherapy or chemotherapy.Counselling.
Does health insurance cover inpatient care?
Health insurance is designed to cover acute conditions that can be resolved with a course of treatment. All basic health insurance policies cover inpatient care needed for this type of condition, so you’ll be covered if you need to stay overnight in the hospital.
What inpatient costs will most medical insurance cover?
Health insurance cover for private inpatient care will usually cover the following costs:
The fees to be paid to your medical team, including your consultant, surgeon, anaesthetist and nursing staff.The cost of the treatment itself, including your medication.Accommodation costs for your stay in the hospital.Any follow-up care you need whilst you’re still in the hospital.
Are there differences between the inpatient cover different insurers offer?
Depending on your health insurance plan, you may also be able to receive inpatient cancer treatment such as radiotherapy and chemotherapy as well as surgery. Some insurers will also cover the blood and other necessary diagnostic tests immediately before surgery. Cancer cover varies depending on your insurance plan, with some insurers including it as standard while others only offering it as an optional extra.
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Does health insurance cover outpatient care?
Some basic private health insurance policies include access to outpatient services after you’ve had inpatient treatment. Generally speaking, outpatient care is only covered if you opt to add it to your policy and pay an additional premium.
If your health insurance only covers inpatient care costs, you can have surgery or other inpatient treatment privately. Then you’ll be discharged to the care of your general practitioner, who’ll see you for check-ups and arrange for you to have follow-up treatment or rehabilitation via the NHS.
You’ll need a more comprehensive private health insurance policy if you want to access private outpatient treatment. Alternatively, you can opt for a basic health insurance policy and add outpatient cover as an optional extra. This will allow you to access outpatient treatments without paying the higher premiums of a more comprehensive policy.
When you opt to have outpatient cover included in your policy, it’s worth comparing the cover level. There’s usually a limit on the amount of outpatient care your insurance plan will pay for. Cover limits are usually £500, £1,000, £1,500 or unlimited.
Why is health insurance more expensive with outpatient treatment?
When insurers set their premiums, they assess the likelihood of someone claiming on the policy. This will include a variety of factors, some of which will relate to you as an individual and others which are more general. These factors mean that including outpatient cover is usually more expensive.
What factors do insurers look at?
The chances of you needing inpatient care for a serious illness or major surgery are much lower than the possibility that you’ll need physiotherapy or minor surgery. Most people will need minor diagnostic tests at some point in life; severe injuries are much rarer.
If you need care on an outpatient basis, it could also carry on for a more extended period, which means that the cost to your insurer will be higher and more difficult to predict.
Can I choose whether to include outpatient cover in my policy?
Yes. Outpatient cover isn’t usually included in health insurance policies as standard, so you can choose whether you want it. The combined cost of the premium for inpatient and outpatient cover is higher than the cost of private inpatient treatment alone.
