Page-outs refer to a file-backed page being committed to disk; these are perfectly normal and expected (program writes to a file, kernel eventually commits to disk). Every OS guarantees that file-backed pages be committed within some reasonably short period of time to reduce the risk of lost data in the event of a power outage (the sync interval).
A high page-out rate doesn't necessarily imply memory pressure; it may simply mean some program running on the system is writing to files frequently. However, memory pressure may temporarily increase the page-out rate if the sync interval hasn't yet kicked in.
Swap-outs, on the other hand, relate to anonymous memory pages (i.e. the heap). Swap-outs, in contrast to page-outs, are generally bad and indicate severe memory pressure.