History and Overview of Inpatient Care

In-patient care refers to care of a patient who is formally admitted (or hospitalized) to an institution for treatment and/or care and stays for a minimum of one night. In-patient care is delivered in hospitals, other nursing homes and residential care facilities or in establishments which are classified according to their focus of care under the ambulatory care. In-patient care includes accommodations provided in combination with medical treatment when the latter is the predominant activity provided during the stay as an in-patient (OECD, 2001).

Three relevant examples and characteristics of in-patient care are:
1. Inpatient Psychiatric Wards
The Institute of Living, offers the following Adult Inpatient Services:
· Acute Grief
· Substance Dependence
· Personality Disorders
· Eating Disorders
The aim is to tailor each person’s treatment plan to the individual needs as much as possible. This is based upon assessment of each patient’s individual needs. Patients are encouraged to attend groups to find commonality in their issues, along with skills, relapse prevention, and leisure skills training.

2. Acute Hospital Setting: Physical Therapy Inpatient Care
Patients who are admitted to an acute hospital setting such as inpatient care in a physical therapy center may have been involved in an accident or have suffered/are suffering from a health problem that has had an effect on their movement.
Patient areas they assist with:
· Cardiac
· Digestive Disease
· Orthopedics
· Trauma,etc.
Physical therapists evaluate each patient and work as part of a team to determine appropriate discharge plans including home, inpatient rehabilitation or skilled nursing, and outpatient services (University of Iowa Hospitals and Clinics, 2007).

3. Hospice Care: Impatient Unit
Hospice care (also called end-of-life care) is provided by health professionals and volunteers. They give medical, psychological and spiritual support. The goal of the care is to help people who are dying have peace, comfort and dignity. The caregivers try to control pain and other symptoms so a person can remain as alert and comfortable as possible. Hospice programs also provide services to support a patient’s family (Medline Plus, 2010).

Cost, quality and Access are connected and influence each other and are a basic concern for patients. If one element is shifted in increase, either one or both would compensate for that change. The better cost, highest quality, and best access are goals for inpatient care providers and the desire of patients. Better access is a result of low prices for inpatient care; those who do not have insurance are less likely to access inpatient care due to cost. Those who receive aid or are insured are more likely to utilize inpatient care. Even for the uninsured who seeks inpatient care may not have access to the best quality due to the lack of funds. Accessible care ultimately improves the quality of life for those who can effectively participate and purchase it. Inpatient care is accessible to retirees, those with complete disabilities, and veterans through Medicare Part A (Hospital Insurance). That insurance covers the first 60 days of hospital inpatient care after a deductible is paid. If further time is needed they are transferred to a skill nursing facility, the first 20 days are covered under the deductible, but care after that will be covered out of pocket

Inpatient care is more important than a competing topic because 92% of hospital revenues come from inpatient care. This is why inpatient care is more important in terms of workforce (it provides wages), financing (it provides most of the financing for hospitals). Hospice Care helps a person maintain dignity and remain comfortable in their last stages of life. General hospitals provide a variety of medicines and surgeries to meet and satisfy the needs of the community. Specialty hospitals can provide care for patients with a certain condition or disease. Specialty hospitals include rehabilitation hospitals (which specialize in therapeutic services) and children’s hospitals (which specialize in the treatment of children). Without these different forms of inpatient care, patients may not get the specialized and individual care they need to return to wellness. There are even more types of hospitals: teaching hospitals, church-affiliated hospitals, and osteopathic hospitals, one of these types of hospitals may fit their own values and beliefs in terms of health care. (More important than health services for special populations the hospitals serve all populations, depending on the needs or wants of patient)

Inpatient care allows follow up and monitoring of patients when they are now well enough to care for themselves. Complications that may arise from a procedure may be detected earlier, under the supervision of health care professionals. In inpatient care, there is actually contact between the patient and the health care professional. Inpatient care includes makes up a sort of umbrella over areas such as workforce, technology, and financing. (This makes inpatient care more important than outpatient care. Complications of outpatient procedures may not be detected and responded to as quickly and efficiently)



Hartford Healthcare. (2010). Inpatient Care. Retrieved from http://www.harthosp.org/InstituteOfLiving/AdultServices/InpatientCare/default.aspx
HospiceCare, Inc. (2010). Inpatient Hospice. Retrieved from: http://www.hospicecareinc.com/inpatient-care.html
MedlinePlus. (2010). Hospice Care. Retrieved from: http://www.nlm.nih.gov/medlineplus/hospicecare.html
OECD Health Data. (2001). A Comparative Analysis of 30 Countries. Retrieved from:
http://stats.oecd.org/glossary/detail.asp?ID=1364
University of Iowa Hospitals and Clinics. (2007). Physical Therapy. Retrieved from: http://www.uihealthcare.com/depts/rehabilitationtherapies/physicaltherapy/inpatient.html
Shi, L, & Singh, D. (2008). Delivering health care in america: a systems approach (4th ed.). Boston: Jones and Bartlett Publishers.

American Cancer Society, Initials. (2009, May 6). What is Hospice care. Retrieved from http://www.cancer.org/docroot/ETO/content/ETO_2_5X_What_IS_Hospice_Care.asp

Beliefs and Values

When it comes to health care, we tend to identify with the Democratic party. We affiliate and agree with the views and beliefs of President Barack Obama. According to President Obama, "... by emphasizing prevention and wellness, it will also help improve the quality of health care for every American." (Walsh, 2009). We believe that health care should be accessible to all and affordable to all. I also believe in holistic care as a secondary action to illness. Once illness and disease is addressed then holistic/wellness can be assessed and accounted for. With this understanding, I also believe that we should provide quality health care for this affordable price.

3 Beliefs and 3 Values:

1. Advancement: The government should provide inpatient facilities that are up to code, provide up-to-date technologies and devices, and allow for future growth in terms of medical advancements.

2. Quality: While the staffing ratios have increased over the years (Shi & Singh, 2008, pg. 304), I believe that we need to increase our staffing ratios in order to provide the best quality of care. It is also important that patients are fully aware of the costs, benefits, and risks of procedures.The point is to provide the best care possible, not just performing wasteful procedures, unnecessary admissions, and unnecessary hospital days. (McCleave, 1999)
3. Affordability: I believe that proprietary hospitals, or for-profit hospitals, should not be allowed to exist. I don't think anyone should be making a profit off of health care. The health care industry should be strictly a non-profit industry. “Social justice regards health care as a social good – as opposed to an economic good – that should be collectively financed and available to all citizens regardless of the individual recipient’s ability to pay for that care” (Shi & Singh, 2008, pg. 58-59). According to Dr. Sharfstein, 92% of hospital revenue comes from inpatient care (Mulligan, 2002).

4. Prevention: Inpatient hospitals should advocate for preventative medicine because patients needing to stay in the hospital for overnight visits or extended periods of time can often prevent these lengths of stay by engaging in preventative medicine throughout the lifetime. Engaging in preventative medicine would reduce medical costs as well as the necessity of medical care. If more of an emphasis is placed on prevention, there will be less need for treatments that are costly and possibly dangerous. Additionally, hospitals should invest more in co-managed care. A Loyola University study showed that patients who had care that was managed by a hospitalist and a surgeon had shorter hospital stays and recovered more quickly.

5. Access: I believe that government should provide funding for those hospitals that cannot function on their own. For example, rural hospitals have had to close in the past, which has limited access for those utilizing those rural hospitals. Specifically, those affected are elderly and poor patients (Shi & Singh, 2008, pg. 312).

6. Ethics: Due to advancements, hospital staff may be faced with ethical challenges. Hospitals should provide training for all employees regarding ethical treatment of patients. Mandatory in-services would ensure that all employees were up to date with education regarding ethical challenges. In addition to these trainings, there should be materials available for all employees to reference and ethics in-service days throughout the year. Ethics are also somewhat of an issue in teaching hospitals especially. Supervisors have to find an ethical balance between quality of care and teaching methods (Sethuramen, 2003).

How might your team's values and beliefs influence inpatient costs, access, and quality:

Costs- If the government were to provide facilities and technology, this would lower the cost that is left for patients to pick up. Additionally, if for-profit hospitals weren't able to exist, these hospitals would charge solely for the care that is provided, which would decrease the patient's responsibility.

Access- If the government were to provide funding for hospitals in rural areas, this would allow those patients, specifically the elderly and poor, to have access to facilities that may have ceased to exist due to financial troubles.

Quality- Providing more staff and technology will result in shorter hospitals stays and better care, which will overall result in improved health.

Sources:

McCleave, S. (1999). Tips for making inpatient care more efficient. Family Practice Management , Retrieved from http://www.aafp.org/fpm/990300fm/45.html

Mulligan, K. (2002). Sharfstein gives survival tips for trouble hospitals. Physchiatric News, 37(15), Retrieved from http://pn.psychiatryonline.org/content/37/15/7.full

Ritter, J. (2009, October 1). How to Reduce hospital stays and increase patient satisfaction. Retrieved from http://www.loyolamedicine.org/News/News_Releases/news_release_detail.cfm?var_news_release_id=973441046

Sethuramen, K. (2003). Ethics of patient care by trainee-doctors in teaching hospitals. Ethics Forum, 49(2), Retrieved from http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=2;spage=159;epage=62;aulast=Sethuraman

Shi, L, & Singh, D. (2008). Delivering health care in america: a systems approach (4th ed.). Boston: Jones and Bartlett Publishers.

Walsh, D. (2009). House democrats unveil health care reform plan. Retrieved from http://www.cnn.com/2009/POLITICS/07/14/house.health.care/index.html

Welcome!

Welcome to our team blog regarding Inpatient Care within the United States. We strive to tackle the issues that have arisen from the U.S. Health Care system and welcome your thoughts and advice. Health Care Reform is not something that occurs overnight and we look forward to your feedback. Thank you!