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Importance of Primary Outpatient Clinic Services
Primary outpatient care, often referred to as ambulatory care, pertains to services or interventions that do not include hospitalization. Common examples of primary outpatient care include annual exams with physicians and cases in which patients leave the emergency units on the same day as their arrival. Appointments at facilities and clinics that are not within a hospital but do not require hospitalization are usually defined by their secondary care nature. As such, primary outpatient care can be defined as being without hospitalization and provided in a hospital setting. This definition allows for the understanding of the importance of such care models. Primary outpatient care provides accessibility, timely services, emergency care, and appropriate interventions for specific medical conditions.
Factors Impacting the Need of Primary Outpatient Clinic Services
The factors that impact the need for primary outpatient care are population sizes, socioeconomic elements, the financial status of the facility, and access to necessary equipment, professionals, and other features. A low socioeconomic level and a high population can increase the need for primary outpatient care as patients may lack alternative care models or the ability to visit other medical facilities. Similarly, a poor financial structure that supports the outpatient facility can cause less efficient care of lower quality (Hochelenert et al., 2018). The inability to access required resources is likely to cause a similar effect. As such, these factors impact the need for primary outpatient care as well as how the model can be manipulated according to variations in external influences.
Associated Fiscal Planning Issues
There are four characteristics that can contribute to issues in the fiscal planning of primary outpatient care models. First, a decline or unexpected rise in patient volumes can adversely affect existing healthcare plans (Ascend National Healthcare Staffing). A decline can indicate a loss of patients to competing facilities. Second, sizable capital expenditures can result in a facility’s inability to acquire the necessary equipment or tools to continue its practice (Ascend National Healthcare Staffing). For instance, the investment in more novel features such as electronic health records can create a financial burden for smaller facilities.
As such, many hospitals may find themselves integrated into a larger health system in order to maintain necessary equipment and devices. Third, a poor understanding of the current cost of care can result in the loss of clients, payers, and other stakeholders (Ascend National Healthcare Staffing). An inability to produce effective cost accounting results may cause a hospital to continue non-profitable services that cause excessive strain rather than effective care. Fourth, primary outpatient care faces the unique fiscal issue of accumulating bad debt through emergency room visits (Ascend National Healthcare Staffing). This often occurs due to visits to the ER being unnecessary but consuming time and resources. As such, it would benefit a hospital to provide patients with educational material regarding when to visit the ER as well as re-direct appropriate cases to non-emergency units.
Associated Human Capital Issues and Needs
The primary outpatient care model requires a high quantity of human capital. However, issues often arise within such facilities as worker shortages, excessive working hours, and inadequate management structure are common (Hochelenert et al., 2018). In order to establish efficient use of human capital within a primary outpatient care structure, it is vital to meet the primary needs of employees and professionals that operate within the field. This requires meeting recurring issues such as lacking work-life balance, working outside of scheduled hours, frequent shifts, inadequate wages, shortages of equipment, inadequate training, and more.
Overview of Products and Services
Currently, primary outpatient care in the U.S. can be defined by interventions, treatments, procedures, and testing that do not include a stay at the hospital, monitoring, or additional care. A recent study found that American citizens with primary care options were more likely to receive high-value care when compared to those without it. Primary outpatient care units were referred to generally to provide better health care experiences and access (Levine et al., 2019). As such, these findings can indicate that current models among healthcare facilities in regard to primary outpatient treatment are efficient and of generally high quality. Policymakers and leaders within healthcare can investigate the issues that reduce more frequent incidents of low-value care and poor experiences.
Overall, primary care outpatient clinics provide distinct services that are vital to providing emergency or other short-term care. While the model is generally profitable and overall efficient throughout, there are issues from both a fiscal and external set of factors that can change the operations and welfare of primary outpatient care. As such, in an economic sense, primary outpatient care is highly susceptible to internal changes regarding expenditures, debt, and distribution of resources and capital. Similarly, elements and issues associated with human capital can similarly influence the ability of a primary outpatient clinic to function independently and sufficiently. External factors such as increases and decreases in patients, socioeconomic levels of the population, and other factors can contribute to the ability of a clinic to provide services. These elements should be considered when observing the overview of primary outpatient clinic models. Smaller clinics with unreliable streams of revenue or patients may suffer and become dysfunctional or may be absorbed into larger health care systems. As such, it may be beneficial to observe the ways in which the primary outpatient care structure functions among clinics of varied sizes and sources of financial support.
Market Analysis
The central products of a primary outpatient clinic include the services and medical resources utilized for patients during their short-term stays. As such, commonly included services such as hospital beds, necessary services for overnight stays, and other long-term necessities such as hygienic products, food, and hospital room elements are not included. This provides an outpatient clinic with reduced expenditure and no requirement to replace certain products such as beds, bedding, and other equipment or furniture. As has been highlighted, emergency and non-hospitalized visits to a clinic are common and present a large portion of the healthcare market. There are no alternative products or services to emergency care that are adequate. As such, it makes the products and services provided by the primary outpatient clinics necessary and with competition only among clinics, facilities, and hospitals. Larger hospitals also spend incredibly high prices for marketing and promotion strategies (Minemyer, 2018). This is less seen among primary outpatient clinics which have limited marketing or advertising that interests them into an existing healthcare system.
However, outpatient clinics are more commonly less profitable due to the fact that hospitalized visits by patients usually allow hospitals to earn higher amounts. Similarly, outpatient clinics are more prone to less stable revenue than inpatient clinics that can ascertain their patient populations more accurately. Overall, the financial performance of primary outpatient clinics is more likely to fluctuate both due to internal management, resource allocation, and external factors. However, an adaptable business model can likely address and modify clinic operations to continue to be profitable even in the case of external influences.
The earnings that come from primary outpatient clinics can vary. Services and medication provide an outline for clear expenditure values, though the overall spending on these elements can vary depending on patient visits. Similarly, losses may occur in the case that patient visits decline unexpectedly and certain products or services are unused. Patients may pay for their services out of pocket or through their insurance. The paying model for individual treatment and interventions can vary according to the type of healthcare model a clinic is a part of or uses as a business model. Overall, in the case that expenditures on services, products, and maintenance are reasonably monitored and acquired, profitability of a primary outpatient clinic can be assumed to be positive.
Budget Planning
The overall operations budget suggests that human resources as well as the purchase of medical supplies will be the highest in terms of expenditure. Unlike inpatient hospitals, an outpatient clinic is less expensive in regards to housekeeping and additional expenses that include comfort and food. As such, the revenue narrative is dependent on the ability to correctly acquire and allocate medical supplies and working staff. Because a decline of patient visits can result in expenses that can be detrimental to a clinic, it is vital for the facility to monitor their average visits and net revenue. With an approximation of five thousand annual visits to her physician with net revenue of approximately $444,481, costs must be kept reasonably below net earnings.
The assumed expenses within the operations of the clinic can be summarized through the purchase of medical expenses, the salaries and benefits of permanent staff, maintenance, equipment, and other expenses. Overall, housekeeping, utilities, and maintenance fees can be safely calculated due to the unlikelihood of them being influenced by external or internal factors (Whittington, 2020). Similarly, benefits and salaries of medical staff are unlikely to be changed much even in the case of patient population decline. However, the volume of bought medical equipment that is not used during appropriate timeframes may cause financial issues for the clinic. As such, it is integral that expense assumptions prioritize the potential lost medical supplies in the case of external influences.
There are a number of instruments and services above the price of a thousand dollars a year that are required to support the welfare of the clinic. Communication and information services such as telephone services and computer equipment are necessary for cohesive treatment administration. With the wide-spread use of electronic health records it is vital for the clinic to provide staff with access to appropriate hardware and software. Similarly, clinics continue to rely on telephone communication to provide care and information. It is also important to maintain the quality of the equipment by obtaining repair and replacement equipment as well as having access to specialists in the case of issues. Security monitoring is also essential for the safe-keeping of physical and electronic records as well as the mitigation of unnecessary risks for patients, medical staff, and other visitors to the clinic.
Medical waste disposal is also a factor when considering the overall safety of the facility, improper disposal can cause catastrophic effects and routine and thorough disposal is essential. Uniform expenses account for the proper and hygienic clothing provided to the employees that assists them with their tasks by being comfortable, recognizable, and specifically created for medical tasks. Technology and services in relation to finances such as credit card processes and payment devices also provide the clinic with effective payment systems and the ability to track profits. Administrative tasks may also require delivery and postage services, and therefore a clinic would benefit from having necessary items such as stamps, parcels, and other delivery-related features.
A smaller primary outpatient clinic requires administrative staff, physicians, and specialists. The front desk, dedicated phone and contact staff, billing staff, and medical records experts. If the patient population is high and physicians or nurses perform strictly medical tasks, administrative staff may have to expand and take on more specialized tasks. However, these four factors are the most integral to the service of a primary outpatient clinic. Experts, nurses, and physicians can be selected based on their ability to perform laboratory, x-ray, and management tasks (Ascend National Healthcare Staffing, n.d.). In the case that a clinic is often substantial in size, a manager physician may be required to oversee the daily process within the clinic.
A laboratory may also be necessary in the case that the clinic is connected to a larger health care system. However, due to the fact that the clinic performs outpatient tasks it may be beneficial to have an on-site laboratory for timely results. Similarly, x-ray equipment may also not be necessary, however due to the fact that the clinic performs emergency care, an x-ray machine may be necessary. Specialists that provide surgery scheduling and specialized testing may also be present in the case of unique incidents in which primary physicians are unable to provide certain care or treatment. The fundamental employees necessary for the clinic include administrative staff, physicians, and specialists, though the number and shared responsibilities may vary according to the size of the clinic.
Executive Summary
According to market analysis, budget planning, and risk analysis, the primary outpatient clinic model provides a cost-effective approach to the healthcare structure. Although several factors and elements can cause an outpatient clinic to suffer economically and operationally, these factors can be addressed with an appropriate spending plan. Observing the marketplace, factors such as declining population and debt are the most influential factors that can cause problems for a primary outpatient clinic. However, the initial planning discussed in this report considers such cases. A clinic part of a more extensive health care system can benefit from adequate structural and financial support to avoid excessive debt. Similarly, by monitoring patient population trends, a clinic can avoid unnecessary expenditures that could lead to a loss of capital and resources. This project should be given the “green light,” as it will allow the clinic to spend efficiently.
The ability to choose a healthcare provider increasingly comes at a high cost to patients and the healthcare system itself. For the government, which finances health care, unregulated access to physicians causes increased costs because a patient may see more than one physician, leading to irrational duplication of services. Patients who wish to have a wider choice of physicians may incur (or increase) user costs. In addition, the integration of the health care system may suffer as a result: the patient will find it more challenging to navigate through the system and will have to spend more time getting from one doctor to another.
Several countries have introduced some form of user payment for doctor consultations, and the extent and level of such payment vary considerably. Generally, user fees reflect a patient’s willingness to pay for a wider choice of physicians. France has recently introduced a model to control access to specialty care. Patients who bypass this mechanism pay higher fees and receive less reimbursement from the state for medical care.
The problem of access to diagnostic services is often considered a significant bottleneck in a patient’s path to care. In countries with a more robust private sector, patients have the choice of going directly to the outpatient department of a hospital or having their general practitioner refer them to a private clinic for a laboratory examination and diagnosis. In both cases, patients often have to wait a long time to be examined by a specialist. This dynamically growing market attracts commercial competitors, mostly overseas, so it’s essential to invest in this plan promptly.
References
Ascend National Healthcare Staffing. (n.d.). How to staff a clinic. Ascend National Healthcare Staffing.
Hochelenert, D., Engels, G., Morbach, S., Schliwa, S., & Game, F. L. (2018). Organisation of an outpatient clinic. In D. Hochelenert, G. Engels, S. Morbach, S. Schliwa, & F. L. Game’s Diabetic Foot Syndrome (pp. 353–360).
Levine, D. M., Landon, B. E., & Linder, J. A. (2019). Quality and experience of outpatient care in the United States for adults with or without primary care. JAMA International Medicine, 179(3), 363-372.
Minemyer, P. (2018). Hospitals spend big bucks on advertising. Here’s a look at the cost of 8 ad campaigns. Fierce Healthcare.
Whittington, H. (2020).2021 budget: operating and capital budget review. Jefferson Healthcare.
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