A review of the extent of outpatient services provided by hospitals in India makes fascinating reading. The extent of the services is gigantic, and the problems of organising them are enormous.
There are still large chunks of population who have no accessibility to medical care, even ambulatory care. According to currently available statistics:
1. a. About 25-35 inpatients are given service per bed in a year.
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b. With 8, 70,160 beds in the country, 2.7 to 3.0 crore inpatients are therefore served per year.
2. a. On the other hand, for each hospital bed, about 600 outpatients per year are given service.
b. This means that over 52 crore outpatients in a year are treated in the outpatient department of hospitals.
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Let us view the problem at a different plane. From 2 to 4 episodes of sickness varying from a mild to moderate to severe nature are suffered by each person in a year.
Considering that only two episodes out of these may require some kind of medical help, 240 crore episodes (for a population of 120 crore) of sickness would need attending to.
Only one-sixth to one-fifth of these persons manages to seek medical care in the outpatient departments of health centres and hospitals. Others seek help from private practitioners, traditional healers, health workers and quacks.
The experience of the National Health Service of UK is similar. Statistics show that every person goes on an outpatient visit in a hospital once a year, visits his or her GP four times a year on an average.
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There has been tremendous increase in the outpatient service all over the world during the last two decades.
In USA outpatient visits increased by 180 per cent in the 15 years between 1951 and 1971 and almost doubled in the next decades again.
As opposed to this, there are examples of developing countries where almost 55 per cent of population is seemingly timid to go to hospital outpatient clinics, because this segment of the people cannot afford the out of pocket expenses due to their deplorable socioeconomic situation.
Much of investigative and diagnostic work that formerly necessitated admission to a hospital can now be carried out in a well-equipped outpatient department, with saving of expenses and avoidance of the disruption of family life that hospitalisation causes.
All patients get their first impression of the hospital from the outpatient department.
It is the first point of contact between the hospital and community and which, in many instances, can make or mar the reputation of the hospital. The importance of the outpatient department lies in the following:
1. An outpatient department is the patient’s first point of contact with the hospital and entry point into the health care delivery system.
2. It is an inseparable link in the hierarchical chain of health care facilities.
3. It contributes to reduction in morbidity and mortality.
4. It is a stepping stone for health promotion and disease prevention.
5. It helps reduce the number of admission to inpatient wards, thus, conserving scarce beds.
6. It acts as a filter for inpatient admissions, ensuring that only those patients are admitted who are most likely to benefit from such care.
7. It is the “shop window” of the hospital.