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Posted: November 7th, 2023
Inpatient services
Inpatient services are the medical services that require hospitalization of patients for more than 24 hours. They are different from outpatient services, which are provided to patients who do not need to stay overnight in a hospital. Inpatient services include various types of care, such as surgery, intensive care, rehabilitation, mental health, and palliative care.
Inpatient services are essential for the diagnosis and treatment of complex and serious medical conditions. They also provide support and comfort to patients and their families during difficult times. However, inpatient services also face many challenges, such as high costs, limited resources, quality issues, and patient safety risks.
One of the main challenges of inpatient services is the high cost of hospitalization. According to a report by the OECD (2021), the average cost per hospital stay in OECD countries was $6,220 in 2019, ranging from $1,340 in Turkey to $21,840 in the United States. The cost of inpatient services is influenced by many factors, such as the length of stay, the type and intensity of care, the use of technology and drugs, and the payment system. The high cost of inpatient services poses a financial burden on patients, insurers, and health systems.
Another challenge of inpatient services is the limited availability and accessibility of hospital beds and staff. The COVID-19 pandemic has exposed the vulnerability of many health systems to cope with sudden surges in demand for inpatient services. The OECD (2020) reported that the average number of hospital beds per 1,000 population in OECD countries was 4.7 in 2018, down from 5.6 in 2000. The number of hospital beds varied widely across countries, from 1.9 in Mexico to 13.0 in Japan. The number and distribution of hospital beds depend on the health system’s capacity, planning, and organization. Similarly, the availability and quality of hospital staff, such as doctors, nurses, and allied health professionals, are crucial for the delivery of inpatient services. However, many countries face shortages and imbalances of health workers, especially in rural and remote areas.
A third challenge of inpatient services is the quality and safety of care. Quality of care refers to the degree to which health services meet the expectations and needs of patients and providers. Safety of care refers to the prevention and reduction of harm caused by health care errors or adverse events. Quality and safety of inpatient services are affected by many factors, such as clinical guidelines, performance indicators, accreditation standards, patient feedback, and adverse event reporting systems. However, there is still room for improvement in many aspects of quality and safety of inpatient services. For example, a study by Panagioti et al. (2019) estimated that about 6% of hospitalized patients experience preventable harm related to their care, such as infections, medication errors, falls, or pressure ulcers.
In conclusion, inpatient services are vital for the health and well-being of many patients who need complex and intensive care. However, they also face significant challenges that require innovative solutions and continuous improvement. Some possible strategies to address these challenges include increasing efficiency and value for money; enhancing access and equity; improving quality and safety; promoting patient-centeredness; and strengthening integration and coordination.
References:
OECD (2020), Health at a Glance 2020: OECD Indicators,
OECD Publishing,
Paris,
https://doi.org/10.1787/4dd50c09-en.
OECD (2021), Health Statistics 2021,
OECD Publishing,
Paris,
https://doi.org/10.1787/health-data-en.
Panagioti M., Khan K., Keers R.N., et al. (2019), Prevalence,
severity,
and nature
of preventable patient harm across medical care settings: systematic review
and meta-analysis,
BMJ,
366:l4185,
https://doi.org/10.1136/bmj.l4185.
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