Hospital - Care, Treatment, Facilities |

 Hospital - Care, Treatment, Facilities | Britannica

Hospitals may be compared and classified in various ways: by ownership and control, by type of service rendered, by length of stay, bysize, 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 som 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, whichnts 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 esses in 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.

 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.

Ine hospitals are owned by religious orders and are contracted to deliver publicly funded services. Other hospitals may be owned by municipalitiesritorial 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 provincary and veterans hospitals have been provided by the 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 privatmbination 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 reven 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.

Privans or agencies exist in many countries. These entities may offer different or more services relative to national health insurance, although generally at additional cost as well. Private insurance funds offem of hospital financing.

The general hospital

General hospitals may be academunity-based entities. They are general in the sense that they admit all types of medical and surgical cases, and they concentrate on  needing relatively short-term ospitals vary in their bed numbers. Each general hospital, however, has an organized medical staff, a professional staff of other health providers (such as nurses, technicians, dietitians, and physiotherapists), and basic diagnostic equipment. In addition to the essential services relating to patient care, and depending on size and location, a community general hospital may also hs.

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 by passing it through semipermeable membranes, as in the artificial kidney), equipment for inhalatiolunteer-services department, and, possibly, a home-care program or access to home-care placement services.

The 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 oion.

The legalwith full responsibility for the conduct and efficient management of the hospital, is usually a hospital 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.

ng for the correct medication from a list behind the counter at a pharmacy.

The administrator is t\re important to the functioning of the hospital include laundry, engineering, stores, purchasing, accounting, pharmacy, physical and occupational therapy, social serviay, and medical records.

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The medical staff is also organized into departments, suc hpecialization of its members and not primarily on the size of the hospital, although there is usually some correlation between the two. The chiefs of the medical-staff departments, along with the chiefs of radiology and pathology, make up the medical advisory board, which usually holds regular meetings on medical-administrative matters. The professional work of the individual staff members is reviewed by medical-staff committees. In a large hospital the committees may report to the medical advisory board; in a smaller hospital, to the medical staff directly, at regular staff meetings.

ill Cornell Medical College, Cornell University, New York City.

General hospitals often also have a formal or an informal role as teaching institutions. When formally designed as such, teaching sionals at a university, and they provide up-to-date and often specialized therapeutic measures and facilities unavailable elsewhere in the region. As teaching hospitals have become more specialized, general hospitals have become more involved in providing general clinical training to students in a variety of health professions.

Specialized health and medical care facilities

Hospitals that specialize in one typ of patient can generally be found in the developed world. In large university centres where postgraduate teaching is carried out on a large scale, such specialized health services often are a department of the general hospital or a satellite operation of the hospital. Changing conditions or modes of treatment have lessened the need or reduced the number of some types of specialized institutions; this may be seen in the carosy, and mental hospitals. On the other hand, specialized surgical centres and cancer centres have increased in number.

Tuberculosis and leprosy hospitals

oking at the chest X-rays of patients infected with tuberculosis.

Between 1880 and 1940, tuberculosis hospitals provided rest, relaxation, special diets, and fresh air, and even if the tuberculosis was in an early stage, a stay of more than two years was thought necessary to effect a healing of the disease; a permanent cure was not considered entirith advances in chest surgery and routine X-ray programs, has meant that the treatment of tuberculosis need not be carried out in a specialized facility.

eatment centre at Kalaupapa, on the island of Molokai, Hawaii.

been known for centuriee established throughout Europe in the Middle Ages to isolate those with leprosy, at that time a common disease, from the community. In the 14th century there may have been some 7,000 leper houses in France alone, and some of the earliest hospitals in England were established for lepers.

Thanks to an intense campaign for leprosy elimination begun in the early 1990s, leprosy is now relatively rare. The purpose of the modern leprosarium is not so much isolation as it id sheltered living in associated villages. Acute leprosy is treated in general hospitals, clinics, and dispensaries.

Mental health facilities

Psychiatric patients traditionally have bre are still facilities that specialize 

The hospital stay of many persons with chronic mental illness has been shortened by modern medication and better understanding on the part of the public. Patients are encouraged to participate in facility-based activities and programs. They may be encouraged to return to the community, beginning with trial visits at home, or they may be placed in assisted-living or group homes. Every effort is now made, through the use of appropriate medication and support services, to have the pcare are no longer isolated from contact with their relatives, friends, and the community at large.

In addition, the strong correlation between mental illness and addiction has been noted and has given rise to numerous programs incorporating the simultaneous treatment of both conditions. Such programs are prevalent in developed countries in particular. In some cases special hospitals addressing both mental illness and addiction have been established—for instance, the Centre for Addiction and Mental Health in Toronto.

Long-term-care facilities

Historically, long-term-care facilities were homes for the elderly, the infirm, and those with chronic irreversible and disabling disorders, especially if the patinal health care but do not need the intensive care found in an acute-care facility. As a result, long-term-care facilities often are staffed with health professionals and are equipped to care for patients with extensive needs for daily living or to help patients prepare to live at home or with a member of the family. Long-term-care facilities represent a significant extension of the hospital health care system, helping to conserve expensive facilities for the acutely ill and improving the prospects of the chronically disabled.

Private hospitals

Many countries haveMedical practice in the towns of developing countries is characterized by a proliferation of many small private hospitals, usually owned by doctors, that have developed to meet the widespread need for hospital care not otherwise available.

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Another method of providing health care in a hospital for those able to pay for it, in both developed and developing countries, is thspital otherwise financed to some degree by public funds. In the United Kingdom and, for example, ibeing required to pay for certain amenities such as a measure of privacy, unrestricted visiting, attractively served food, and a more liberal routine. Alternatively, many large general hospitals are able to offer much more costly accommodations in so-called private blocks—that is, in a part of the hospital specially designed and equipped for private patients. Patients in a private block pay a larery.

Wholly independent private hospitals sometimes are run by a company or busi

The hospice

Historically m the beginning it had a strong religious connection and exemplified the Christian insistence on compassion and care for the aged, the infirm, the needy, and the ill. In modern Britain the hospice movement developed gradually from its beginning in 1905, when thame known for its pealdwide.

Mission hospitals

The spread of Westonal medicine) and the founding of hospitals in developing countries can be attributed in large part to the influence of the medical missionary. The establishment of mission hospitals gained momentum gradually in the second half of the 19th century. By the second half of the 20th century, however, this steady growth had already dwindled, since all but a few of the hospitals and dispensaries founded during that hundred years had been absorbed into the native health care system. The Christian missionaries had a great influence on the creation of centres of Western medicine in many developing countries andd, many of whom would not otherwise have survived. The medical missionaries also promoted the idea and the ideals of nursing as a profession for native men and women.

Apart from its religious associations, a mission hospital functions as a general hospital in the sense that it admits all who need hospital care. A number of mission hospitals, however, have been devoted to specific diseases—for example, leprosy and diseases Perhaps the most important contribution made by mission hospitals is in the enormous numbers of persons, particularly women and children, who have been treated as outpatients.

Extended health care

nitor showing information about heart function for multiple patients in an intensive care unit.

With the advance in medicever-increasing cost of hospital operations, the progressive-care concept is more attractive, both for outpatient and inpatient care. Progressive care can be divided into five categories: (1) intensive care, (2) intermediate care, (3) self-care, (4) long-term care, and (5) organi

Self-care facilities are organized into separate units in wspital cafeteria. Such a ward or wing of a general hospital requires much less costly equipment than the intensive- or intermediate-care units and can be staffed with far fewer nurses and aides.

ed with a range of individuequired for proper care; (3) the nursing service has found that  does not need hospital care; (5) the family environment would have a therapeutic effect, and family members or others can be taught to provide the necessary care; and (6) the family and the patient prefer that care be provided at home. Home care conserves expensive acute-care beds, and most patients on home care do as well as or better than expected.

Regional planning

There are several useful historical and modern example

In the early 2st century, regional planning of hospital services in Sweden was highly organized. The country was divided into health service regions and had three different levels of health care: primary (general practitioner), secondary (small hospitals that offered most medical specialities), and tertiary (university hospitals, one each for the six main health service regions). Several of the country’s hospital facilities had about 1,000 bee not necessarily administered as part of the hospital system.

During its existence thpitals, served populations as small as 2,000 to 15,000 persons. The next-larger hospitals, the district hospitals, had 250–500 beds and usually had divisions for surgical, medical, obstetric, and pediatric services and provided care for infectious diseases. Patients who could not be treated adequately in the district hospitals were referred to the next-higher level, the regional hospital, which served a population of 1,000,000–5,000,000 people and contained up to 1,250 beds. The republic hospital, often associated.

Regional planning i of progressive patient care. The system focused on the efficient provisio facilities of the system; the more serious cases were referred to the inner hospitals of the ring or to the research and teaching hospital at the core.

Tand decides where specialized services are to be delivered and what services or number of beds are to be added. However, in the United States most hospitals are not government-operated, and it is often difficult to achieve close cooperation between voluntary groups.

Iources, and apply government health policies. However, several jurisdictions favoured more centralized models, with one or a small number of authorities directing the delivery of all services.