After completing this chapter, the reader should have an understanding of:
• The definition of ambulatory care. • The variety of settings for the delivery of ambulatory care. • The importance of ambulatory care services as a part of the U.S. health care system. a number of other ways ambulatory care is delivered, and they are described in this chapter. In recent years the number and type of ambulatory or outpatient facilities have increased to allow more patients to receive treatment outside of the more costly acute care hospitals. Because of advances in technology and technique, many of the procedures formerly done in hospitals can now be performed on an outpatient basis. More familiar ambulatory care facilities, such as hospital outpatient departments and community health centers, have expanded to include surgery centers, diagnostic imaging centers, cardiac catheterization laboratories, and other freestanding facilities. Some facilities are for-profit and are operated by chains, either independently owned or affiliated with a hospital. In other cases, nonprofit health care systems with hospitals have expanded their ambulatory facilities as part of an integrated, cost-efficient way to provide care. When we address health care comprehensively, it is also important to recognize pharmacies, dental care, and “alternative” care such as chiropractic as fitting into what we categorize as ambulatory care. We look now at just a few of the major types of ambulatory care.
Ambulatory care covers a wide range of services for the noninstitutionalized patient and in its most basic description is simply care that does not require an overnight stay by the patient. Office-based physicians provide the majority of ambulatory care. An estimated 787.4 million visits were made to doctors’ offices in 1997, or about 3.0 visits per person (Woodwell, 1999). More than 50 percent of those visits were made to primary care
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