OPD Treatment & Day Care Treatment: Find Similarities and Differences in Them

When it comes to purchasing health insurance, there are numerous factors to consider before making a final decision. The sum insured, OPD treatment coverage, premium charged, day care treatment cover, claim settlement process, inclusions and exclusions are a few factors to consider when deciding on the type of health policy to purchase.

In a hurry, many health insurance policy buyers ignore the essential features of the policy. Keep reading this post to learn about the difference between Daycare treatment and OPD treatment. 

What is OPD treatment or Outpatient Treatment?

OPD stands for the outpatient department. Generally, in this, the patient is not hospitalised. It involves regular checkup visits at a doctor's chambers or clinic for a specific treatment. Moreover, the treatment can be carried out by the medical practitioner in their own clinic. 

A health insurance policy with OPD expenses coverage covers doctor consultations, pathological tests and investigations. It can also cover day care treatment, dental as well as the expenses related to maternity treatment. 

Outpatient Department (OPD) treatment is much similar to daycare treatment, however, both can be differentiated based on the type of hospitalisation required in either of the above cases. Let's look at it this way: in an OPD treatment, an individual is required to get the entire procedure done without having to be admitted to the hospital. However, to trigger a claim, in a daycare procedure, an individual is required to get admitted to the hospital no matter even if it is for a short duration. A good example of OPD here would be root canal treatment, which could be looked at and treated by routinely going to a dentist's clinic without needing to get admitted to a hospital.

Advantages of OPD Treatment

• Convenience and Flexibility: OPD treatment provides the convenience of scheduling appointments at preferred times, minimising wait times and enabling patients to choose suitable healthcare providers and facilities. It allows individuals to maintain their daily routines and work commitments while receiving medical care.
• Lower Cost for Routine Care: OPD treatment is typically more cost-effective than inpatient care. Patients can save on expenses related to hospitalisation, such as room charges and meals. Insurance premiums and expenses are often lower, reducing the financial burden on patients.
• Reduced Risk of Hospital-Acquired Infections: OPD settings pose a lower risk of hospital-acquired infections since patients do not stay overnight. Hospitals can be breeding grounds for infectious diseases, and shorter visits in OPD settings reduce exposure. This advantage is especially significant for individuals with weakened immune systems or chronic conditions.

What is a Day Care Treatment or Day Care Procedure?

Daycare treatment, also known as daycare procedure, is a technically advance treatment that takes a few hours to get completed. 

The insured person does not have to spend a lot of time in the hospital. Additionally, there is no need of a 24-hour hospital stay A few daycare procedures include dialysis, chemotherapy, tonsillectomy, cataract surgery, dental surgery (following an accident), and many others. 

Let's use Mr. Anand Mathur as an example, who is getting corrective eye surgery at a reputable facility, to further comprehend this. Long time ago, he was compelled to get himself admitted at a hospital for at least a few days. However, the development of techniques like ICL (Implantable Contact Lens) and LASIK therapy has reduced a lengthy day-long operation to something that can be completed in about an hour. Hence, Mr Mathur got his surgery done and received coverage as a part of the daycare procedure expense.

Advantages of Day Care Treatment:

• Ability to Handle More Complex Cases: Daycare treatment facilities are equipped to manage a wide range of complex medical conditions. Unlike traditional outpatient settings, they can accommodate cases that require specialised equipment, monitoring, and interventions. This capability allows patients with challenging health issues to receive the necessary care without hospitalisation.
• Continuous Medical Supervision: Daycare treatment offers patients the advantage of continuous medical supervision during their stay. Highly trained healthcare professionals closely monitor patients, ensuring their safety and timely intervention if complications arise. This constant oversight can provide patients and their families with peace of mind.
• Faster Recovery for Certain Conditions: For specific medical conditions, daycare treatment can lead to quicker recovery compared to other treatment options. This is particularly true for procedures or therapies that benefit from close monitoring and immediate medical attention. Patients can return to their normal routines sooner, minimising disruptions to their lives.

Similarity between OPD Treatment & Day Care Treatment  

OPD Treatment and Day Care Treatment share some common features. Just like the OPD treatment person chooses for a health insurance policy, they undergo treatment for their medical ailment for a short duration in day care treatment too. Hence, it concludes that both types of medical treatments demands less time. 

Differences between OPD Treatment & Day Care Treatment  

• Hospital admission - While in the case of daycare treatment, hospitalisation is compulsory for less than 24 hours, outpatient treatment does not require hospitalisation.
• Coverage Scope - While most health insurance policies cover daycare procedures (treatment covered may vary from policy to policy), OPD treatment expenses are generally excluded from health insurance policies unless specifically mentioned.
• Coverage Level - While daycare procedures are covered up to the sum insured, without any limit on the coverage of treatment (except for a few), OPD treatment is not covered up to the sum insured and it comes with a sub-limit.

OPD Treatment & Day Care Treatment - The Claim Process

• OPD Treatment - In the case of OPD treatment, expenses can be claimed after the submission of the required documents. OPD reimbursements are subject to sub-limits.
• Daycare procedures - In this type of treatment, making a claim seems like the one for regular hospitalisation. One can easily avail of the benefit of the cashless system by undergoing the procedure in a network hospital. The insured needs to intimate the health insurance provider before hospitalisation and submit all the necessary documents. In the case of a non-network hospital, the insured can claim reimbursement by submitting documents within 7 days.

Conclusion 

As now you have understood the meaning, similarities, and differences between the OPD treatment and the daycare procedure, keep all the points in mind while choosing a policy. In order to make a well-informed decision, it is expected of health insurance plan buyers to examine and read all the mentioned terms and conditions in the policy document carefully.

FAQs:

Q1. What is OPD treatment or Outpatient Treatment?

OPD stands for the outpatient department, where patients receive treatment without hospitalisation. It includes regular visits to a doctor's clinic for specific treatments, and OPD coverage in health insurance includes doctor consultations, tests, and investigations.

Q2. What are the advantages of OPD Treatment?

OPD treatment offers convenience and flexibility in scheduling appointments. It is typically more cost-effective for routine care compared to inpatient treatment. Additionally, it reduces the risk of hospital-acquired infections due to shorter visits.

Q3. What is Day Care Treatment or Day Care Procedure?

Daycare treatment is a technically advanced treatment that can be completed in a few hours without the need for a 24-hour hospital stay. Examples include dialysis, chemotherapy, cataract surgery, and dental surgery following an accident.

Q4. What are the advantages of Day Care Treatment?

Daycare treatment facilities can handle complex medical cases, offering continuous medical supervision for patient safety. They also often lead to faster recovery for specific conditions, minimising disruptions to daily life.

Q5. What are the similarities between OPD and Day Care Treatment?

Both OPD and Day Care Treatment share the characteristic of short treatment durations and do not require extended hospital stays. They are suitable for patients with time-sensitive medical needs.

Q6. What are the differences between OPD and Day Care Treatment?

Daycare treatment necessitates hospital admission for less than 24 hours, whereas OPD treatment does not. Coverage scope and limits vary between the two, with OPD expenses generally excluded unless specified. The claim process also differs, with OPD reimbursements subject to sub-limits, while daycare procedures often follow standard hospitalisation claim processes.