History of hospitals

 

History of hospitals

As early as 4000 bce, religions identified certain of their deities with healing. The temples cognized as healing centres. Brahmanic hospitals were establishe hospitals in Hindustan about 230 bce. Around 100 bce the Romans established hospitals (valetudinaria) for the treatment of their sick and injured soldiers; their care was important because it was upon the integrity of the legions that the powe based.

It can be said, however, that the modern concept of a hospital dates from 331 ce when Roman emperoed all pagan hospitals and thus created the opportunity for a new start. Until that time disease had isolated the sufferer from the community. The Christian tradition emphasized the close relationship of the sufferer to the members of the community, upon whom rested the obligation for care. Illness thus became a matter for the Christian church.

About 370 ce nd the sick. Following this example, similar hospitals were later built in the eastern part of theo, founded early in the 6th century, where the care of the sick was placed above and before every other Christian duty. It was from this beginning that one of the first medical schools in Europe ultimately grew at Salerno and was of high repute by the 11th century. This example led to the establishment of similar monastic infirmaries in the western part of the empire.

Tblished a high reputation and later became one of the most important centres in Europe for the training of doctors. By far the greater number of hospitals established during the Middle Ages, however, were monastic institutions uno are credited with having founded more than 2,000.

The Middle Ages also saw the beginnings of support for hospital-like institutiohorities. Toward the end of the 15th century, many cities and towns supported some kind of institutional health care: it has been said that in England there were no fewer than 200 such establishments that met a growing social need. This gradual transfer of responsibility for institutional health care from the church to civil authorities continued in Europe after the dissolution of the monasteries in 154ch put an end to in England for some 200 years.

The loss of monastic hospitals in England caused the secular authorities to provide for the sick, the injured, and the handicapped, thus laying the foundation for the voluntary hospital movement. The first voluntary hospital in England was probably established in 1718 by’s Hospital in 1724, and the London Hospital in 1740. Between 1736 and 1787, hospitals were established outside London in at least 18 cities. ands. The French established a hos9 at Quebec city, the Hôtel-Dieu du Précieux Sang, which is still in operation (as the Hôtel-Dieu de Québec), although not at its original location. In 16 noblewoman, built a hospital of ax-hewn logs on the island of Montreal; this was the beginning ofory of the present-daid to have been a hospital for soldiers on Manhattan Island, established in 1663.

The early hospitals were primarily almshouses, one of the first of which was established by English Quaker leader and colonisn 1751.

The modern hospital

Hospitals may be compared and classified in various ways: by ownership and control, by type of service rendered, by length of stay, by size, or by facilities and administration provided. Examples include the general hospital, the specialized hospital, the short-stay hospital, and the long-term-care facility.

Bed number and length of stay

Hospitals may be compared by the number of beds they contain. Modern hospitals tend to rarely exceed 800 beds, and though soIn the early 21st century, it was thought that a facility of 800 beds was the largest unit that could be governed satisfactorily from a single administrative unit while maintaining a corporate unity.

Another index is the average bed-occupancy rate—that is, the percentage of available beds actually occupied per day or per month. Bed-occupancy rates may be higher in the cold winter months,  more than 100 percent—there are more patients in the hospital than there are beds for them. This situation has also emerged in some developed countries where demand for services has outstripped supply.

The amount of time that a patient spends in a hospital bed, or the average length of stay (ALOS), is another important index and depends on the nature of the hospital. In an acute-care hospital the ALOS will be relatively short. In hospitals catering to th a single patient). In hospitals in developing countries, the ALOS is much shorter than in developed countries.

Ownership and control

The issues of hospital ownership and control underwent significant analysis and change in the late 20th and early 21st centuries. Such transformation was prevalent in developed countries, particularly those in which fiscal sustainability was problematic.

 Hospital, a National Health Service hospital in England.

In many countries nearly all hospitals are owned and operated by the government. In Gre answers directly to the regional hospital board and ultimately to the Department of Health and Social Security. I. In some instances hospitals that are part of a regional health authority are governed by the board of the regional authority, and hence these hospitals no longer have their own boards.

Ils are owned by religious orders and are contracted to deliver publicly funded services. Other hospitals may be owned by municipial governments.

Worldwide, many hospitals are associated with universities; others were founded by religious groups or by public-spirited individuals. Mental health facilities traditionally have been the responsibility of state or prov federal government. In addition, there are a number of municipal and county general hospitals.

Financing

Because hospitals may serve specific populations and because they may be not-for-profit or for-profit, there exist a variety of mechanisms for hospital financing. Almost universally, hospital-construction costs are met at least in some part by governmental contributions. Operating costs, however, are taken care of in different ways. For example, funds may come from privands of some unit of government, funds collected by insurance carriers from subscribers, or some combination thereof. In some countries, operating costs may be supplemented in part by public or private sources that pay charges on uninsured or inadequately insured patients or by out-of-pocket payment by these individuals.

In many countries, and in Europe in particular, the financial support of services in hospitals tends to be collectivized, with funding provided through public revenudirectly by patients. Details vary somewhat from country to country. I, most hospital operating costs are financed by public revenues collected by regional governments. Many other European countries follow a similar model, with operating costs for hospitals paid out of national insurance funds; such is the case in the Netherlands, Finland, Norway, and elsewhere. In contrast, other countries, such as the United States, rely heavily on private insurance funds.

Private health insurance corporations or agencies exist in many countries. These entities may offer different or more services relative to ntional health insurance, although generally at additional cost as well. Private insurance funds

The general hospital

General hospitals may be academlatively short-term caipment. In addition to the essential services relating to patient care, and depending on size and location, a community general hospital may also hadepartment. Smaller hospitals may diagnose and stabilize patients prior to transfer to facilities with specialty services.

Patient undergoing dialysis treatment.

In larger hospitals there may be additional facilities: dental services, a nursery for premature infants, an organ bank for use in transplantation, a department of ren complexity of the general hospital is in large part a reflection of advances in diagnostic and treatment technologies. Such advances range from the 20th-century introduction of antibiotics and laboratory procedures to the continued emergence of new surgical techniques, new materials and equipment for complex therapies (e.gospital board. The board establishes policy and, on the advice of a medical advisory board, appoints a medical staff and an administrator. It exercises control over expenditures and has the responsibility for maintaining professional standards.

pharmacistA pharmacist searching for the correct medication from a list behind the counter at a pharmacy.

The administrator is thital there are many separate departments, each of which is controlled by a department head. The largest department in any hospital s , and medical