March 14, 2018 | Net Health

3 Minute Read

Inpatient Physical Therapy versus Outpatient: Important Differences

A greater emphasis on preventative care in physical therapy, along with an aging population in need of physical, speech and occupational therapy, has led to rapid growth in rehabilitation services. To meet demand, physical therapy services are now provided in a number of post-acute care settings.

Two of these options, inpatient rehab therapy, and outpatient physical therapy clinics, are among the most popular. Rehab therapy can refer to physical, speech and language, or occupational therapy treatment.

So, what’s the difference between these similar, yet distinct offerings? How do inpatient rehab and acute care differ?

What is Inpatient Physical Therapy?

Inpatient rehabilitation or inpatient physical therapy is typically reserved for individuals who have more complex rehabilitative needs, such as recovering from a serious injury or a stroke where more intensive therapy treatments from an interdisciplinary team are required.

People generally receive inpatient rehabilitation or inpatient physical therapy in a skilled nursing facility (SNF) or inpatient rehab facility (IRF) following hospitalization for a health event and need to be in an environment where they can receive skilled care and oversight before transitioning to the home.

While SNF therapy is inpatient, outpatient physical therapy requires patients travel.

To be eligible for inpatient rehabilitation services under Medicare, care must be determined by a physician as medically necessary. It generally requires a physical rehabilitation therapy program consisting of three hours of therapy per day at least five days per week or, in certain cases, as much as 15 hours of intensive rehabilitation therapy within a seven-consecutive day period, beginning with the date of admission.

Similar to inpatient rehabilitation, to be eligible for skilled nursing rehab services under Medicare Part A, individuals need to have had a qualifying hospital stay, and the doctor needs to have determined that skilled therapy care is required.

What is Outpatient Physical Therapy?

Outpatient physical therapy allows people to receive therapy in their community, usually at a local clinic, and often treat patients with similar medical conditions as those in an inpatient setting. The difference is that patients visiting a clinic tend to have conditions that, while acute in nature, are less medically complex, with fewer comorbidities.

For instance, a first-time stroke patient with no other medical history or complications may get treatment in an outpatient clinic, while a patient dealing with multiple strokes and other medical issues would more likely be treated in an inpatient rehabilitation facility.

What do Outpatient Physical Therapy Clinics Provide?

Outpatient physical therapy is ideal for patients looking to improve their daily mobility and quality of life—but are independent enough to receive these services while living in their home or community. Physical therapy tends to focus on helping patients restore function following an injury, so they can get back to their normal activities.

Much like the other medically complex conditions in inpatient care, requiring close medical supervision that physical therapists, occupational therapists and speech therapists (rehabilitation staff) clinic may also provide other types of services, such as pre- or post-surgery rehab, biofeedback, aquatic therapy and more to help patients stay health and maintain strength.

Seeing a physical therapist at a clinic is also a great option for physical therapy services that aren’t offered within the community or school system, such as voice or speech therapy for children with developmental delays. Speech therapy can also be offered in inpatient rehab by a medical team, although less likely.

Inpatient rehab programs in the hospital or nursing home rehab program deal more with acute cases and physical medicine. After an initial evaluation and comprehensive evaluation, inpatient rehab physical therapists will typically only see a patient while they are admitted, discharge planning then referring the patient in inpatient rehabilitation programs to new physical therapists or nursing care on a multidisciplinary team who can follow up on the treatment plan with outpatient therapy sessions. Care management and treatment leave the hospital at that point in favor of outpatient therapy services.

The patient has an individualized care plan of rehabilitation containing treatment and daily tasks to help rehabilitation of the injury or healing post-surgery. Unlikely to re-enter the hospital, barring illness or injury, they may also receive help from a family member or self care. While not one of the benefits of an inpatient hospital rehab program, being under their own care and free from the hospital can be rewarding.

Visits to an outpatient clinic rehab program for physical therapy tend to be 45-60 minutes in length, and patients often continue their outpatient care exercises at home in between sessions to help them get and stay healthy.

Medicare patients are eligible to receive outpatient physical therapy or treatment under Medicare Part B and, because the therapy caps were repealed, they will benefit from improved access to these services

Market Demand for Rehab Therapy is Growing

From 1994 to 2014, outpatient care grew by 81%. This will likely continue to increase as healthcare continues to serve an aging population that will nearly double in size by 2050. By offering a lower cost to inpatient therapy, plus being more convenient and less risky alternative to traditional inpatient facility methods, outpatient physical therapists and therapy clinics are well-positioned to play an important and growing role in the physical therapy post-acute care continuum.

These are just a few of the main differences between outpatient clinics and inpatient rehab therapy. While both outpatient and inpatient rehabilitation programs play a vital role in the recovery process, knowing which setting is best – outpatient programs or inpatient rehab – depends on the patient’s condition and the intensity of therapy needs.

For patients, it’s always suggested for them to consult with their doctor to find which physical therapist setting is best for their ailment.

A good outpatient or inpatient rehabilitation program offers physical therapy to help reduce pain, improve join mobility, hand therapy, determine proper exercises, address chronic pain, recover from surgery, and help alleviate symptoms allowing patients to work with therapists to improve patient quality of life. Just like inpatient rehab, Outpatient therapy services addresses this an a wider range of issues and injuries, including prevention.

Share this post

Subscribe and See More