What Are Key Clinical Differences between Inpatient and Outpatient Physical Therapy

A greater emphasis on preventative care, 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.

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

What is Inpatient Rehab Therapy?

Inpatient rehab 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 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.

To be eligible for IRF rehab services under Medicare, care must be determined by a doctor as medically necessary. It generally requires a 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.

Similarly, 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 facility.

Outpatient clinics are 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. Therapy tends to focus on helping patients restore function following an injury, so they can get back to their normal activities.

Clinics may also provide other types of services, such as pre- or post-surgery rehab, biofeedback, aquatic therapy and more. Clinics are also a great option for services that aren’t offered within the community or school system, such as voice or speech therapy for children with developmental delays.

Visits to an outpatient clinic tend to be 45-60 minutes in length, and patients often continue their exercises at home in between sessions.

Medicare patients are eligible to receive outpatient therapy under Medicare Part B and, because the therapy caps were repealed, they will benefit from improved access to these services.

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Market Demand for Rehab Therapy is Growing

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

These are just a few of the main differences between outpatient therapy clinics and inpatient rehab therapy. While they both play a vital role in the recovery process, knowing which setting is best suited for a patient 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 setting is best for their ailment.

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