Array ( [0] => {{Short description|Health care facility with specialized staff and equipment}} [1] => {{Other uses}} [2] => {{Redirect|General hospital|the US daytime TV series|General Hospital}} [3] => {{pp-move}} [4] => {{Use dmy dates|date=March 2023}} [5] => [[File:Hospital-de-Bellvitge.jpg|thumb|The exterior of [[Bellvitge University Hospital]] in [[L'Hospitalet de Llobregat]], Spain, with entrance and parking area for ambulances.]] [6] => {{Public Infrastructure}} [7] => A '''hospital''' is a healthcare institution providing patient treatment with specialized [[Medical Science|health science]] and auxiliary healthcare staff and medical equipment.{{Cite web|url=https://www.who.int/hospitals/en/|title=Hospitals|website=World Health Organization|language=en-GB|access-date=24 January 2018}} The best-known type of hospital is the general hospital, which typically has an [[emergency department]] to treat urgent health problems ranging from fire and accident victims to a sudden illness. A district hospital typically is the major health care facility in its region, with many beds for [[intensive care]] and additional beds for patients who need long-term care. [8] => [9] => Specialized hospitals include [[trauma center]]s, [[rehabilitation hospital]]s, [[children's hospital]]s, [[geriatric]] hospitals, and hospitals for specific medical needs, such as [[psychiatric hospital]]s for [[psychiatry|psychiatric]] treatment and other disease-specific categories. Specialized hospitals can help reduce [[health care costs]] compared to general hospitals.{{cite web|url=https://www.bbc.co.uk/news/health-10830889|title=India's 'production line' heart hospital|publisher=bbcnews.com|date=1 August 2010|access-date=13 October 2013}} Hospitals are classified as general, specialty, or government depending on the sources of income received. [10] => [11] => A [[teaching hospital]] combines assistance to people with teaching to health science students and [[Allied Healthcare|auxiliary healthcare]] students. A health science facility smaller than a hospital is generally called a clinic. Hospitals have a range of departments (e.g. surgery and [[urgent care]]) and specialist units such as [[cardiology]]. Some hospitals have [[outpatient|outpatient departments]] and some have chronic treatment units. Common support units include a [[hospital pharmacy|pharmacy]], [[pathology]], and [[radiology]]. [12] => [13] => Hospitals are typically funded by [[publicly funded healthcare|public funding]], health organizations ([[For-profit hospital|for-profit]] or nonprofit), [[health insurance]] companies, or charities, including direct charitable donations. Historically, hospitals were often founded and funded by [[religious orders]], or by charitable individuals and leaders.{{cite journal|last=Hall|first=Daniel|title=Altar and Table: A phenomenology of the surgeon-priest|journal=Yale Journal of Biology and Medicine|date=December 2008|volume=81|issue=4|quote=Although physicians were available in varying capacities in ancient [[Rome]] and [[Athens]], the institution of a hospital dedicated to the care of the sick was a distinctly [[Christianity|Christian]] innovation rooted in the monastic virtue and practise of hospitality. Arranged around the monastery were concentric rings of buildings in which the life and work of the monastic community was ordered. The outer ring of buildings served as a hostel in which travellers were received and boarded. The inner ring served as a place where the monastic community could care for the sick, the poor and the infirm. Monks were frequently familiar with the medicine available at that time, growing medicinal plants on the monastery grounds and applying remedies as indicated. As such, many of the practicing physicians of the Middle Ages were also clergy.|pmc=2605310|pmid=19099050|pages=193–98}} [14] => [15] => Hospitals are currently staffed by professional physicians, surgeons, nurses, and [[Allied health professions|allied health practitioners]]. In the past, however, this work was usually performed by the members of founding religious orders or by [[volunteering|volunteers]]. However, there are various Catholic religious orders, such as the [[Alexians]] and the [[Bon Secours Sisters]] that still focus on hospital ministry in the late 1990s, as well as several other Christian denominations, including the Methodists and Lutherans, which run hospitals.{{cite book|last=Lovoll|first=Odd|title=A Portrait of Norwegian Americans Today|year=1998|publisher=U of Minnesota Press|isbn=978-0-8166-2832-2|page=192}} In accordance with the original meaning of the word, hospitals were original "places of hospitality", and this meaning is still preserved in the names of some institutions such as the [[Royal Hospital Chelsea]], established in 1681 as a retirement and nursing home for veteran soldiers. [16] => {{TOC limit}} [17] => [18] => ==Etymology== [19] => [[File:Hospital.svg|alt=White H on blue background, used to represent hospitals in the US.|thumb|During peacetime, hospitals are often marked by symbols. A white 'H' on a blue background is often used in the United States. During military conflicts, a hospital may be marked with the emblem of the [[Emblems of the International Red Cross and Red Crescent Movement|red cross, red crescent or red crystal]] in accordance with the [[Geneva Conventions]].]] [20] => During the Middle Ages, hospitals served different functions from modern institutions in that they were [[almshouses]] for the poor, [[hostel]]s for [[pilgrims]], or hospital schools. The word "hospital" comes from the [[Latin language|Latin]] {{lang|la|hospes}}, signifying a stranger or foreigner, hence a guest. Another noun derived from this, {{lang|la|hospitium}} came to signify hospitality, that is the relation between guest and shelterer, hospitality, friendliness, and hospitable reception. By [[metonymy]], the Latin word then came to mean a guest-chamber, guest's lodging, an [[inn]].''Cassell's Latin Dictionary'', revised by J. Marchant & J. Charles, 260th. thousand. {{lang|la|Hospes}} is thus the root for the English words ''host'' (where the ''p'' was dropped for convenience of pronunciation) ''[[hospitality]]'', ''[[hospice]]'', ''hostel,'' and ''hotel''. The latter modern word derives from Latin via the [[Old French]] romance word {{lang|fro|hostel}}, which developed a silent ''s'', which letter was eventually removed from the word, the loss of which is signified by a [[circumflex]] in the [[French language|modern French]] word {{lang|fr|hôtel}}. The German word {{lang|de|Spital}} shares similar roots. [21] => [22] => =={{anchor|Types}}Types== [23] => Some patients go to a hospital just for [[Medical diagnosis|diagnosis]], treatment, or therapy and then leave ("[[outpatients]]") without staying overnight; while others are "admitted" and stay overnight or for several days or weeks or months ("[[inpatients]]"). Hospitals are usually distinguished from other types of medical facilities by their ability to admit and care for inpatients whilst the others, which are smaller, are often described as [[clinics]]. [24] => [25] => ===General and acute care{{anchor|General hospital|General}}=== [26] => {{redirect|General hospital|the American soap opera|General Hospital|other uses}} [27] => The best-known type of hospital is the general hospital, also known as an acute-care hospital. These facilities handle many kinds of disease and injury, and normally have an emergency department (sometimes known as "accident & emergency") or [[trauma center]] to deal with immediate and urgent threats to health. Larger cities may have several hospitals of varying sizes and facilities. Some hospitals, especially in the United States and Canada, have their own ambulance service. [28] => [29] => ===District=== [30] => {{Main article|Regional hospital}} [31] => A district hospital typically is the major health care facility in its region, with large numbers of beds for [[intensive care]], [[Critical care medicine|critical care]], and long-term care. [32] => [33] => In California, "district hospital" refers specifically to a class of healthcare facility created shortly after [[World War II]] to address a shortage of hospital beds in many local communities.{{cite web|title=Our Background|url=http://www.cadhlf.org/about-dhlf/our-background/|url-status=dead|archive-url=https://web.archive.org/web/20140714153446/http://www.cadhlf.org/about-dhlf/our-background/|archive-date=14 July 2014|access-date=10 July 2014|publisher=District Hospital Leadership Forum}}{{cite web|last1=Knox|first1=Dennis|title=District Hospitals' Important Mission|url=http://payersandproviders.com/opinion-detail.php?id=97|url-status=dead|archive-url=https://web.archive.org/web/20140714155325/http://payersandproviders.com/opinion-detail.php?id=97|archive-date=14 July 2014|access-date=10 July 2014|publisher=Payers &–° Providers}} Even today, district hospitals are the sole public hospitals in 19 of California's counties, and are the sole locally accessible hospital within nine additional counties in which one or more other hospitals are present at a substantial distance from a local community. Twenty-eight of California's rural hospitals and 20 of its critical-access hospitals are district hospitals. They are formed by local municipalities, have boards that are individually elected by their local communities, and exist to serve local needs. They are a particularly important provider of healthcare to uninsured patients and patients with [[Medi-Cal]] (which is California's [[Medicaid]] program, serving low-income persons, some [[senior citizens]], persons with [[disabilities]], children in [[foster care]], and pregnant women). In 2012, district hospitals provided $54 million in uncompensated care in California. [34] => [35] => ===Specialized=== [36] => [[File:Starship Children's Health Auckland.jpg|thumb|[[Starship Children's Health]], a [[children's hospital]] in [[Auckland]], New Zealand]] [37] => [[File:McMasterUMedical.jpg|thumb|[[McMaster University Medical Centre]], a teaching hospital in [[Hamilton, Ontario]]]] [38] => [[File:AIIMS -New Delhi's Ward Block.jpg|thumb|[[All India Institute of Medical Sciences, New Delhi]], a large teaching hospital in [[India]]]] [39] => A specialty hospital is primarily and exclusively dedicated to one or a few related [[Medical specialty|medical specialties]].{{cite web|year=2004|title=Specialty Hospital Update|url=https://legacy.npr.org/programs/morning/features/2004/dec/hospitals/klein.pdf|access-date=25 July 2020|website=National Public Radio}} Subtypes include [[rehabilitation hospital]]s, [[children's hospital]]s, seniors' ([[geriatric]]) hospitals, [[Long-term acute care facility|long-term acute care facilities]], and hospitals for dealing with specific medical needs such as [[psychiatry|psychiatric]] problems (see [[psychiatric hospital]]), [[List of cancer hospitals|cancer treatment]], certain disease categories such as cardiac, oncology, or orthopedic problems, and so forth. [40] => [41] => In [[Germany]], specialised hospitals are called ''Fachkrankenhaus''; an example is [[Fachkrankenhaus Coswig]] (thoracic surgery). In India, specialty hospitals are known as ''super-specialty hospitals'' and are distinguished from multispecialty hospitals which are composed of several specialties.{{Cite web|title=Scope of Single Super Speciality Hospitals|url=https://healthcare.siliconindia.com/viewpoint/cxoinsights/scope-of-single-super-speciality-hospitals-nwid-11073.html|access-date=6 July 2020|website=healthcare.siliconindia.com|publisher=Siliconindia.com|location=India}} [42] => [43] => Specialised hospitals can help reduce [[health care costs]] compared to general hospitals. For example, [[Narayana Health]]'s cardiac unit in [[Bangalore]] specialises in cardiac surgery and allows for a significantly greater number of patients. It has 3,000 beds and performs 3,000 in paediatric cardiac operations annually, the largest number in the world for such a facility.{{cite web|url=http://www.fastcompany.com/node/153 |title=Narayana Hrudayalaya Hospitals |publisher=fastcompany.com |date=7 February 2012 |access-date=13 October 2013 |url-status=dead |archive-url=https://archive.today/20131013225342/http://www.fastcompany.com/node/153 |archive-date=13 October 2013 }} Surgeons are paid on a fixed salary instead of per operation, thus when the number of procedures increases, the hospital is able to take advantage of [[economies of scale]] and reduce its cost per procedure. Each specialist may also become more efficient by working on one procedure like a [[production line]]. [44] => [45] => ===Teaching=== [46] => {{Main|Teaching hospital}} [47] => A [[teaching hospital]] delivers healthcare to patients as well as training to prospective [[medical professionals]] such as [[medical students]] and student [[Nursing|nurses]]. It may be linked to a medical school or nursing school, and may be involved in [[medical research]]. Students may also observe clinical work in the hospital.{{Cite web|title=What's a Teaching Hospital?|url=https://www.brennerchildrens.org/KidsHealth/Parents/QandA/Parenting/Whats-a-Teaching-Hospital.htm|access-date=13 June 2020|website=www.brennerchildrens.org}} [48] => [49] => ===Clinics=== [50] => Clinics generally provide only [[outpatient]] services, but some may have a few inpatient beds and a limited range of services that may otherwise be found in typical hospitals. [51] => [52] => ==Departments or wards== [53] => A hospital contains one or more wards that house [[hospital bed]]s for [[inpatient]]s. It may also have acute services such as an [[emergency department]], [[operating theatre]], and [[intensive care unit]], as well as a range of medical specialty departments. A well-equipped hospital may be classified as a trauma center. They may also have other services such as a [[hospital pharmacy]], [[radiology]], [[pathology]], and [[medical laboratories]]. Some hospitals have outpatient departments such as [[behavioral health]] services, [[dentistry]], and [[Physical medicine and rehabilitation|rehabilitation services]]. [54] => [55] => A hospital may also have a [[Nursing management|department of nursing]], headed by a [[chief nursing officer]] or [[Nursing management#Director of nursing|director of nursing]]. This department is responsible for the administration of professional nursing practice, [[Nursing research|research]], and policy for the hospital. [56] => [57] => Many units have both a nursing and a medical director that serve as administrators for their respective disciplines within that unit. For example, within an intensive care nursery, a medical director is responsible for physicians and medical care, while the nursing manager is responsible for all the nurses and nursing care. [58] => [59] => Support units may include a [[medical records department]], [[release of information department]], [[technical support]], [[clinical engineering]], facilities management, [[plant operations]], dining services, and security departments. [60] => [61] => [62] => File:Hospital-beds-per-1000-people.png|alt=Hospital beds per 1000 people 2013.|Hospital beds per 1000 people 2013{{cite web |title=Hospital beds per 1,000 people |url=https://ourworldindata.org/grapher/hospital-beds-per-1000-people?year=2013 |website=Our World in Data |access-date=7 March 2020}} [63] => File:Hospital beds in OECD.svg|Hospital beds per inhabitants [64] => File:ER room after a trauma.jpg|[[Resuscitation]] room bed after a [[physical trauma|trauma]] intervention, showing the highly technical equipment of modern hospitals [65] => [66] => [67] => ===Remote monitoring=== [68] => The [[COVID-19 pandemic]] stimulated the development of virtual wards across the British [[NHS]]. Patients are managed at home, monitoring their own oxygen levels using an oxygen saturation probe if necessary and supported by telephone. [[West Hertfordshire Hospitals NHS Trust]] managed around 1200 patients at home between March and June 2020 and planned to continue the system after COVID-19, initially for respiratory patients.{{cite journal |title=The "virtual wards" supporting patients with covid-19 in the community |journal=BMJ |date=5 June 2020 |volume=2020 |issue=369 |page=m2119 |url=https://www.bmj.com/content/369/bmj.m2119#: |access-date=24 December 2020}} [[Mersey Care NHS Foundation Trust]] started a COVID Oximetry@Home service in April 2020. This enables them to monitor more than 5000 patients a day in their own homes. The technology allows nurses, carers, or patients to record and monitor vital signs such as blood oxygen levels.{{cite news |title=Modern technology reduces hospital admissions |url=https://www.buildingbetterhealthcare.com/news/article_page/Modern_technology_reduces_hospital_admissions/172302/cn164706 |access-date=27 January 2021 |publisher=Building Better Healthcare |date=2 December 2020}} [69] => [70] => ==History== [71] => {{main|History of hospitals}} [72] => [73] => === Early examples === [74] => {{See also|Ancient Egyptian medicine||Ancient Greek medicine|Medicine in ancient Rome|Medical community of ancient Rome}} [75] => In early [[India]], [[Fa Xian]], a Chinese Buddhist monk who travelled across India {{Circa|AD 400}}, recorded examples of healing institutions.{{cite book|title=A Record of Buddhistic Kingdoms: Being an Account by the Chinese Monk Fâ-Hien of his Travels in India and Ceylon (AD 399–414) in Search of the Buddhist Books of Discipline|last=Legge|first=James|year=1965|publisher=Dev Publishers & Distributors}}{{Page needed|date=August 2013}} According to the ''[[Mahavamsa]]'', the ancient chronicle of Sinhalese royalty, written in the sixth century AD, King [[Pandukabhaya of Sri Lanka]] (r. 437–367 BC) had lying-in-homes and hospitals (Sivikasotthi-Sala).Arjuna Aluvihare, "Rohal Kramaya Lovata Dhayadha Kale Sri Lankikayo" ''Vidhusara Science Magazine'', November 1993. A [[Academy of Guneshapur|hospital and medical training center]] also existed at [[Gundeshapur]], a major city in southwest of the [[Sassanid Persian Empire]] founded in AD 271 by [[Shapur I]].''The American Journal of Islamic Social Sciences 22:2'' Mehmet Mahfuz Söylemez, ''The Gundeshapur School: Its History, Structure, and Functions'', p. 3. In [[ancient Greece]], temples dedicated to the healer-god [[Asclepius]], known as [[Asclepeion]] functioned as centers of medical advice, prognosis, and healing.[[Guenter B. Risse|Risse, G.B.]] ''Mending bodies, saving souls: a history of hospitals.'' 1990. p. 56 The Asclepeia spread to the [[Roman Empire]]. While public healthcare was non-existent in the Roman Empire, military hospitals called ''valetudinaria'' did exist stationed in military barracks and would serve the soldiers and slaves within the fort.Ziegler, Tiffany A., Tiffany A. Ziegler, and Troyanos. Medieval Healthcare and the Rise of Charitable Institutions. Springer International Publishing, 2018, 33. Evidence exists that some civilian hospitals, while unavailable to the Roman population, were occasionally privately built in extremely wealthy Roman households located in the countryside for that family, although this practice seems to have ended in 80 AD.(Guenter Risse, Mending Bodies, Saving Souls: A History of Hospitals, 47–48). [76] => [77] => [78] => File:Kos Asklepeion.jpg|View of the ''Askleipion'' of [[Kos]], the best preserved instance of an Asklepieion [79] => File:Sri Lankan Traditional Medicine.jpg|Ruins of a two thousand-year-old hospital were discovered in the historical city of [[Anuradhapura]] [[Mihintale]] Sri Lanka. [80] => [81] => [82] => ===Middle Ages=== [83] => {{See also|Byzantine medicine|Medieval medicine of Western Europe|Medicine in the medieval Islamic world}} [84] => The declaration of [[Christianity]] as an accepted religion in the Roman Empire drove an expansion of the provision of care.{{cite web|first = Jaroslav |last = Jan Pelikan|url=https://www.britannica.com/topic/Christianity/Church-and-social-welfare#ref67595|title=Christianity: Curing and caring for the sick|date =13 August 2022 |publisher=[[Encyclopædia Britannica]]}} Following the [[First Council of Nicaea]] in AD 325 construction of a hospital in every cathedral town was begun, including among the earliest hospitals by [[Sampson the Hospitable|Saint Sampson]] in [[Constantinople]] and by [[Basil of Caesarea|Basil, bishop of Caesarea]] in modern-day Turkey.''Catholic Encyclopedia'' – ''[http://www.newadvent.org/cathen/07480a.htm]'' (2009) Accessed April 2011. By the twelfth century, Constantinople had two well-organised hospitals, staffed by doctors who were both male and female. Facilities included systematic treatment procedures and specialised wards for various diseases.[[Byzantine medicine]][[File:Door of the Moristan of Kala'oon (1878) - TIMEA.jpg|thumb|left|Entrance to the [[Qalawun complex]] in Cairo, Egypt, which housed the notable Mansuri hospital]] [85] => [86] => The earliest general hospital in the Islamic world was built in 805 in [[Baghdad]] by [[Harun Al-Rashid]].Husain F. Nagamia, ''[Islamic Medicine History and Current practise]'', (2003), p. 24.{{citation |last=Glubb |first=Sir John Bagot |title=A Short History of the Arab Peoples |url=http://www.cyberistan.org/islamic/quote2.html#glubb |year=1969 |access-date=25 January 2008 |author-link=John Bagot Glubb}} By the 10th century, Baghdad had five more hospitals, while [[Damascus]] had six hospitals by the 15th century, and [[Córdoba, Andalusia|Córdoba]] alone had 50 major hospitals, many exclusively for the military, by the end of the 15th century.{{cite web|url=http://www.aramcoworld.com/en-US/Articles/March-2017/The-Islamic-Roots-of-the-Modern-Hospital|title=The Islamic Roots of the Modern Hospital|publisher=aramcoworld.com|access-date=20 March 2017}} The Islamic [[bimaristan]] served as a center of medical treatment, as well [[nursing home]] and [[lunatic asylum]]. It typically treated the poor, as the rich would have been treated in their own homes.[https://www.nlm.nih.gov/exhibition/islamic_medical/islamic_12.html Islamic Culture and the Medical Arts: Hospitals], [[United States National Library of Medicine]] {{PD-notice}} Hospitals in this era were the first to require medical licenses for doctors, and compensation for negligence could be made.{{Cite journal |last=Miller |first=Andrew C |date=2006 |title=Jundi-Shapur, bimaristans, and the rise of academic medical centres |journal=Journal of the Royal Society of Medicine |volume=99 |issue=12 |pages=615–617 |doi=10.1177/014107680609901208 |issn=0141-0768 |pmc=1676324 |pmid=17139063 |quote=Another lasting advancement made during this time period was that of physician licensure. In 931 AD Caliph Al-Muqtadir learned that a patient had died in Baghdad as a result of a physician's error. Consequently, he ordered Sinan ibn Thabit to examine all those who practiced the art of healing. Of the 860 medical practitioners he examined, 160 failed. From that time on, licensing examinations were required and administered in various places. Licensing boards were set up under a government official called Muhtasib, or inspector general. The chief physician gave oral and practical examinations, and if the young physician was successful, the Muhtasib administered the Hippocratic Oath and issued a license to practice medicine.}}{{Cite journal|title=From Jami'ah to University: Multiculturalism and Christian–Muslim Dialogue|first=Syed Farid|last=Alatas|journal=Current Sociology|volume=54|issue=1|pages=112–32|doi=10.1177/0011392106058837|year=2006|s2cid=144509355|url=https://zenodo.org/record/29439}} Hospitals were forbidden by law to turn away patients who were unable to pay.{{Cite web |title=Islamic Culture and the Medical Arts: Hospitals |url=https://www.nlm.nih.gov/exhibition/islamic_medical/islamic_12.html |archive-url=https://web.archive.org/web/20240121222733/https://www.nlm.nih.gov/exhibition/islamic_medical/islamic_12.html |archive-date=2024-01-21 |access-date=2024-01-21 |website=www.nlm.nih.gov}} These hospitals were financially supported by [[waqf]]s, as well as state funds. [87] => [88] => In India, [[public hospital]]s existed at least since the reign of [[Firuz Shah Tughlaq]] in the 14th century. The [[Mughal emperors|Mughal]] emperor [[Jahangir]] in the 17th century established hospitals in large cities at government expense with records showing salaries and grants for medicine being paid for by the government.{{Cite book|author=Ikram, Sheikh Mohamad|title = Muslim Civilization in India|pages = 223|year = 1964|isbn = 978-0-231-02580-5|chapter = Economic and Social Developments under the Mughals| publisher=Columbia University Press }} [89] => [90] => In China, during the [[Song Dynasty]], the state began to take on social welfare functions previously provided by Buddhist monasteries and instituted public hospitals, [[hospice]]s and [[Public dispensary|dispensaries]].{{cite journal| pmc=| pmid=| doi=10.1097/MC9.0000000000000041 | volume=6 | title=Reacting to Epidemics: The Innovative Imperial Public Health System during the Late Northern Song Dynasty | year=2023 | author=Goldschmidt, Asaf| journal=Chinese Medicine and Culture| issue=1 | pages=68–75| doi-access=free}} [91] => [92] => ===Early modern and Enlightenment Europe=== [93] => [[File:Ancien-Hopital.jpg|thumb|A hospital ward in 6th century [[France]]]] [94] => In Europe the medieval concept of Christian care evolved during the 16th and 17th centuries into a secular one. In [[England]], after the [[dissolution of the monasteries]] in 1540 by King [[Henry VIII]], the church abruptly ceased to be the supporter of hospitals, and only by direct petition from the citizens of London, were the hospitals [[St Bartholomew's Hospital|St Bartholomew's]], [[St Thomas's Hospital|St Thomas's]] and [[Bethlem Royal Hospital|St Mary of Bethlehem's]] (Bedlam) endowed directly by the crown; this was the first instance of secular support being provided for medical institutions. [95] => [96] => In 1682, [[Charles II of England|Charles II]] founded the [[Royal Hospital Chelsea]] as a retirement home for old soldiers known as [[Chelsea Pensioners]], an instance of the use of the word "hospital" to mean an [[almshouse]].''The Royal Hospital Chelsea'' (Norwich: Jarrold Publishing, 2002), pp. 3–4 Ten years later, [[Mary II of England|Mary II]] founded the [[Greenwich Hospital, London|Royal Hospital for Seamen, Greenwich]], with the same purpose.J. Bold, P. Guillery, D. Kendall, ''Greenwich: an architectural history of the Royal Hospital for Seamen and the Queen's House'' (Yale University Press, 2001), pp. 4–7 [97] => [[File:Guy's Hospital00.jpg|thumb|left|1820 engraving of [[Guy's Hospital]] in London, one of the first voluntary hospitals to be established in 1724]] [98] => [[File:Ruinas San Nicolas de Bari CCSD 09 2018 1414.jpg|thumb|Ruins of the [[Hospital San Nicolás de Bari]] in [[Santo Domingo]], [[Dominican Republic]], recognized by UNESCO for being the oldest hospital built in the Americas.{{cite web|url=https://whc.unesco.org/en/list/526|title=Colonial City of Santo Domingo. Outstanding Universal Value|website=UNESCO World Heritage Centre website}}{{cite web|url=https://www.lonelyplanet.com/dominican-republic/santo-domingo/attractions/ruinas-del-hospital-san-nicolas-de-bari/a/poi-sig/1182163/358037|website=[[Lonely Planet]]|title=Ruinas del Hospital San Nicolás de Barí}} Built between 1514 and 1541.]] [99] => [[File:Pennsylvania Hospital (Highsmith).png| thumb | [[Pennsylvania Hospital]] (now part of [[University of Pennsylvania Health System]]). Founded in 1751, it is the earliest established public hospital in the United States.{{cite book | title=America's First Hospital: The Pennsylvania Hospital, 1751–1841 | url=https://archive.org/details/americasfirsthos0000will | url-access=registration | publisher=Haverford House | author=Williams, William Henry | year=1976 | isbn=978-0-910702-02-7}}{{Citation [100] => | url = https://npgallery.nps.gov/AssetDetail/NRIS/66000688 [101] => | title = NPGallery Digital Asset Management System: Pennsylvania Hospital [102] => | work = National Register of Historic Places [103] => | publisher = [[National Park Service]] [104] => | access-date = 30 July 2019 [105] => | ref = none [106] => }}{{efn|"Although Philadelphia General Hospital (1732) and Bellevue Hospital in New York (1736) are older, the Philadelphia General was founded as an almshouse, and Bellevue as a workhouse."}} It is also home to America's first surgical amphitheatre and its first medical library.]] [107] => [108] => The [[voluntary hospital]] movement began in the early 18th century, with hospitals being founded in London by the 1720s, including [[Westminster Hospital]] (1719) promoted by the [[private bank]] [[C. Hoare & Co]] and [[Guy's Hospital]] (1724) funded from the bequest of the wealthy merchant, [[Thomas Guy]]. [109] => [110] => Other hospitals sprang up in London and other British cities over the century, many paid for by private subscriptions. St Bartholomew's in London was rebuilt from 1730 to 1759,{{Cite web | url=http://www.bl.uk/onlinegallery/onlineex/kinggeorge/p/003ktop00000025u021g0000.html |title = Painted window in St Bartholomew's Hospital}} and the London Hospital, Whitechapel, opened in 1752. [111] => [112] => These hospitals represented a turning point in the function of the institution; they began to evolve from being basic places of care for the sick to becoming centers of medical innovation and discovery and the principal place for the [[medical education|education]] and training of prospective practitioners. Some of the era's greatest surgeons and doctors worked and passed on their knowledge at the hospitals.{{Cite book|author=Reinarz, Jonathan|title = Brain, Mind and Medicine: Essays in Eighteenth-Century Neuroscience|pages = 43–52|doi = 10.1007/978-0-387-70967-3_4|year = 2007|isbn = 978-0-387-70966-6|chapter = Corpus Curricula: Medical Education and the Voluntary Hospital Movement}} They also changed from being mere homes of refuge to being complex institutions for the provision and advancement of medicine and care for sick. The [[Charité]] was founded in Berlin in 1710 by King [[Frederick I of Prussia]] as a response to an outbreak of plague. [113] => [114] => Voluntary hospitals also spread to [[Colonial America]]; [[Bellevue Hospital]] in [[New York City]] opened in 1736, first as a workhouse and then later as a hospital; [[Pennsylvania Hospital]] in [[Philadelphia]] opened in 1752, [[Weill Cornell Medical Center|New York Hospital]], now Weill Cornell Medical Center{{cite web | title = General Acute Care Hospital in New York | url = https://npidata.net/category/general-acute-care-hospital/ny/ | access-date = 6 October 2019 | archive-date = 16 February 2023 | archive-url = https://web.archive.org/web/20230216194027/https://npidata.net/category/general-acute-care-hospital/ny/ | url-status = dead }} in New York City opened in 1771, and [[Massachusetts General Hospital]] in [[Boston]] opened in 1811. [115] => [116] => When the [[Vienna General Hospital]] opened in 1784 as the world's largest hospital, physicians acquired a new facility that gradually developed into one of the most important research centers.Roderick E. McGrew, ''Encyclopedia of Medical History'' (Macmillan 1985), p. 139. [117] => [118] => Another [[Age of Enlightenment|Enlightenment]] era charitable innovation was the dispensary; these would issue the poor with medicines free of charge. The London Dispensary opened its doors in 1696 as the first such clinic in the [[British Empire]]. The idea was slow to catch on until the 1770s,{{cite journal| pmc=5308110 | pmid=28126876 | doi=10.3399/bjgp17X689281 | volume=67 | title=Books: The Dispensaries: Healthcare for the Poor Before the NHS: Britain's Forgotten Health-care System: Dispensaries: An Alternative to General Practice? | year=2017 | author=Freeman GK | journal=Br J Gen Pract | issue=655 | page=81}} when many such organisations began to appear, including the [[Public Dispensary of Edinburgh]] (1776), the Metropolitan Dispensary and Charitable Fund (1779) and the [[Finsbury Dispensary]] (1780). Dispensaries were also opened in New York 1771, [[Philadelphia]] 1786, and Boston 1796.{{cite book|author1=Michael Marks Davis|author2=Andrew Robert Warner|title=Dispensaries, Their Management and Development: A Book for Administrators, Public Health Workers, and All Interested in Better Medical Service for the People|url=https://archive.org/details/dispensariesthei00daviuoft|year=1918|publisher=MacMillan|pages=[https://archive.org/details/dispensariesthei00daviuoft/page/2 2]–3}} [119] => [120] => The [[Royal Naval Hospital, Stonehouse]], [[Plymouth]], was a pioneer of hospital design in having "pavilions" to minimize the spread of infection. [[John Wesley]] visited in 1785, and commented "I never saw anything of the kind so complete; every part is so convenient, and so admirably neat. But there is nothing superfluous, and nothing purely ornamented, either within or without." This revolutionary design was made more widely known by [[John Howard]], the philanthropist. In 1787 the French government sent two scholar administrators, [[Charles-Augustin de Coulomb|Coulomb]] and [[Jacques-René Tenon|Tenon]], who had visited most of the hospitals in Europe.Surgeon Vice Admiral A Revell in http://www.histansoc.org.uk/uploads/9/5/5/2/9552670/volume_19.pdf They were impressed and the "pavilion" design was copied in France and throughout Europe. [121] => [122] => ===19th century=== [123] => [[File:'One of the wards in the hospital at Scutari'. Wellcome M0007724 - restoration, cropped.jpg|thumb|A ward of the hospital at [[Üsküdar|Scutari]], where [[Florence Nightingale]] worked and helped to restructure the modern hospital]] [124] => English physician [[Thomas Percival]] (1740–1804) wrote a comprehensive system of medical conduct, ''[[Medical Ethics; or, a Code of Institutes and Precepts, Adapted to the Professional Conduct of Physicians and Surgeons]]'' (1803) that set the standard for many textbooks.{{cite journal | author = Waddington Ivan | year = 1975 | title = The Development of Medical Ethics – A Sociological Analysis | journal = Medical History | volume = 19 | issue = 1| pages = 36–51 | doi=10.1017/s002572730001992x| pmid = 1095851 | pmc = 1081608 }} In the mid-19th century, hospitals and the medical profession became more professionalised, with a reorganisation of hospital management along more bureaucratic and administrative lines. The [[Apothecaries Act 1815]] made it compulsory for medical students to practise for at least half a year at a hospital as part of their training.{{cite book | pages=316–17 | last=Porter |first=Roy |author-link=Roy Porter | title=The Greatest Benefit to Mankind: A Medical History of Humanity from Antiquity to the Present | publisher=W.W. Norton & Company | location=New York | isbn=978-0-393-31980-4 |orig-year=1997 |year=1999}} [125] => [126] => [[Florence Nightingale]] pioneered the modern profession of nursing during the [[Crimean War]] when she set an example of compassion, commitment to patient care and diligent and thoughtful hospital administration. The first official nurses' training programme, the Nightingale School for Nurses, was opened in 1860, with the mission of training nurses to work in hospitals, to work with the poor and to teach.{{cite book|url=https://archive.org/details/fundamentalsofme0000neeb|url-access=registration|title=Fundamentals of Mental Health Nursing|author=Kathy Neeb|year=2006|publisher=Philadelphia: F.A. Davis Company|isbn=978-0-8036-2034-6}} Nightingale was instrumental in reforming the nature of the hospital, by improving [[sanitation]] standards and changing the image of the hospital from a place the sick would go to die, to an institution devoted to recuperation and healing. She also emphasised the importance of [[statistics|statistical measurement]] for determining the success rate of a given intervention and pushed for [[Public administration|administrative reform]] at hospitals.{{cite book |url=https://books.google.com/books?id=dRpgFsQ7nqkC&q=sanitary+commissioner+Scutari&pg=PA114 |title=Florence Nightingale: Measuring Hospital Care Outcomes |date=August 1999 |access-date=13 March 2010 |isbn=978-0-86688-559-1 |author1=Nightingale, Florence |publisher=Joint Commission on Accreditation of Healthcare Organizations }}{{Dead link|date=March 2024 |bot=InternetArchiveBot |fix-attempted=yes }} [127] => [128] => By the late 19th century, the modern hospital was beginning to take shape with a proliferation of a variety of public and private hospital systems. By the 1870s, hospitals had more than trebled their original average intake of 3,000 patients. In continental Europe the new hospitals generally were built and run from public funds. The [[National Health Service]], the principal provider of health care in the United Kingdom, was founded in 1948. During the nineteenth century, the Second Viennese Medical School emerged with the contributions of physicians such as [[Carl Freiherr von Rokitansky]], [[Josef Škoda]], [[Ferdinand Ritter von Hebra]], and [[Ignaz Philipp Semmelweis]]. Basic medical science expanded and specialisation advanced. Furthermore, the first dermatology, eye, as well as ear, nose, and throat clinics in the world were founded in [[Vienna]], being considered as the birth of specialised medicine.[[Erna Lesky]], ''The Vienna Medical School of the 19th Century'' (Johns Hopkins University Press, 1976) [129] => [130] => ===20th century and beyond=== [131] => {{Globalize section|the United States|date=August 2020}} [132] => By the late 19th and early 20th centuries, medical advancements such as [[anesthesia]] and sterile techniques that could make surgery less risky, and the availability of more advanced diagnostic devices such as [[X-ray#Discovery|X-rays]], continued to make hospitals a more attractive option for treatment. [133] => [134] => Modern hospitals measure various efficiency metrics such as occupancy rates, the average length of stay, time to service, patient satisfaction, physician performance, patient readmission rate, inpatient mortality rate, and [[case mix index]].{{Cite web|title=Hospital Industry's 10 Most Critical Metrics – Guiding Metrics|url=https://guidingmetrics.com/content/hospital-industrys-10-most-critical-metrics/|access-date=25 November 2018|website=guidingmetrics.com|language=en-US}} [135] => [136] => In the [[United States]], the number of hospitalizations grew to its peak in 1981 with 171 admissions per 1,000 Americans and 6,933 hospitals.{{Cite news | url=https://www.nytimes.com/2018/02/25/opinion/hospitals-becoming-obsolete.html | title=Opinion | Are Hospitals Becoming Obsolete?| journal=The New York Times| date=25 February 2018| last1=Emanuel| first1=Ezekiel J.}} This trend subsequently reversed, with the rate of hospitalization falling by more than 10% and the number of US hospitals shrinking from 6,933 in 1981 to 5,534 in 2016.{{cite web | url=https://www.aha.org/statistics/fast-facts-us-hospitals | title=Fast Facts on U.S. Hospitals, 2018 | AHA}} Occupancy rates also dropped from 77% in 1980 to 60% in 2013.{{Cite news|title=As admissions have slumped and outpatient care booms, hospitals closing or shrinking|language=en-us|work=Modern Healthcare|url=https://www.modernhealthcare.com/article/20150221/MAGAZINE/302219988|access-date=25 November 2018}} Among the reasons for this are the increasing availability of more complex care elsewhere such as at home or the physicians' offices and also the less therapeutic and more life-threatening image of the hospitals in the eyes of the public.{{Cite web |title=Estimating Health Care-Associated Infections and Deaths in U.S. Hospitals, 2002 |url=http://www.cdc.gov/HAI/pdfs/hai/infections_deaths.pdf |url-status=deviated |archive-url=https://web.archive.org/web/20111015060229/http://www.cdc.gov/HAI/pdfs/hai/infections_deaths.pdf |archive-date=2011-10-15 |access-date=2023-09-09 |website=[[Centers for Disease Control and Prevention]]}} In the US, a patient may sleep in a hospital bed, but be considered outpatient and "under observation" if not formally admitted.{{Cite web|title=Two-Midnight and Observation Rule – Chicago Medical Society|url=http://www.cmsdocs.org/news/two-midnight-and-observation-rule|url-status=live|archive-url=https://web.archive.org/web/20181125023815/http://www.cmsdocs.org/news/two-midnight-and-observation-rule|archive-date=25 November 2018|access-date=25 November 2018|website=www.cmsdocs.org}} [137] => [138] => In the U.S., inpatient stays are covered under Medicare Part A, but a hospital might keep a patient under observation which is only covered under Medicare Part B, and subjects the patient to additional coinsurance costs. In 2013, the [[Centers for Medicare and Medicaid Services|Center for Medicare and Medicaid Services]] (CMS) introduced a "two-midnight" rule for inpatient admissions,{{Cite news|title=CMS drops two-midnight rule's inpatient payment cuts|language=en-us|work=Modern Healthcare|url=https://www.modernhealthcare.com/article/20160418/NEWS/160419922|access-date=25 November 2018}} intended to reduce an increasing number of long-term "observation" stays being used for reimbursement. This rule was later dropped in 2018. In 2016 and 2017, healthcare reform and a continued decline in admissions resulted in US hospital-based healthcare systems performing poorly financially.{{Cite news|date=5 October 2017|title=How U.S. Hospitals and Health Systems Can Reverse Their Sliding Financial Performance|work=Harvard Business Review|url=https://hbr.org/2017/10/how-u-s-hospitals-and-health-systems-can-reverse-their-sliding-financial-performance|access-date=25 November 2018}} Microhospitals, with bed capacities of between eight and fifty, are expanding in the United States.{{Cite web|last=Staff|title=5 common questions about micro-hospitals, answered|url=https://www.beckershospitalreview.com/facilities-management/5-common-questions-about-micro-hospitals-answered.html|access-date=25 November 2018|website=www.beckershospitalreview.com|language=en-gb}} Similarly, freestanding emergency rooms, which transfer patients that require inpatient care to hospitals, were popularised in the 1970s{{Cite web|date=7 September 2011|title=When the tiny hospital can't survive: Free-standing EDs with primary care seen as new rural model|url=https://www.modernhealthcare.com/article/20140927/MAGAZINE/309279952/when-the-tiny-hospital-can-t-survive-free-standing-eds-with-primary-care-seen-as-new-rural-model|access-date=14 May 2019|website=Modern Healthcare|language=en}} and have since expanded rapidly across the United States. [139] => [140] => The [[Catholic Church]] is the largest non-government provider of [[Catholic Church and health care|health careservices]] in the world.{{cite journal|last=Agnew|first=John|title=Deus Vult: The Geopolitics of Catholic Church|journal=Geopolitics|date=12 February 2010|volume=15|issue=1|pages=39–61|doi=10.1080/14650040903420388|s2cid=144793259}} It has around 18,000 clinics, 16,000 homes for the elderly and those with special needs, and 5,500 hospitals, with 65 percent of them located in developing countries.Calderisi, Robert. ''Earthly Mission - The Catholic Church and World Development''; TJ International Ltd; 2013; p.40 In 2010, the Church's [[Pontifical Council for the Pastoral Care of Health Care Workers]] said that the Church manages 26% of the world's health care facilities.{{cite web|url=http://www.catholicnewsagency.com/news/catholic_hospitals_represent_26_percent_of_worlds_health_facilities_reports_pontifical_council/ |title=Catholic hospitals comprise one quarter of world's healthcare, council reports :: Catholic News Agency (CNA) |publisher=Catholic News Agency |date=10 February 2010 |access-date=2012-08-17}} [141] => [142] => ==Funding== [143] => [[File:KB Dubrava Zagreb.jpg|thumb|[[Clinical Hospital Dubrava]] in [[Zagreb]], Croatia]] [144] => Modern hospitals derive funding from a variety of sources. They may be funded by private payment and [[health insurance]] or [[public expenditure]], [[charitable donation]]s. [145] => [146] => In the [[United Kingdom]], the National Health Service delivers health care to legal residents funded by the state "free at the point of delivery", and emergency care free to anyone regardless of nationality or status. Due to the need for hospitals to prioritise their limited resources, there is a tendency in countries with such systems for 'waiting lists' for non-crucial treatment, so those who can afford it may take out private health care to access treatment more quickly.{{cite web |url=http://www.nzherald.co.nz/organisation/story.cfm?o_id=366&objectid=10487870 |title=Surgery worries create insurance boom |author=Johnston, Martin |date=21 January 2008 |website=[[The New Zealand Herald]] |access-date=3 October 2011}} [147] => [148] => In the [[United States]], hospitals typically operate privately and in some cases on a [[Business|for-profit]] basis, such as [[HCA Healthcare]]. The list of procedures and their prices are billed with a [[chargemaster]]; however, these prices may be lower for health care obtained within [[Hospital network|healthcare networks]].{{Cite journal|url=https://www.ajmc.com/journals/issue/2017/2017-vol23-n4/battling-the-chargemaster-a-simple-remedy-to-balance-billing-for-unavoidable-out-of-network-care|title=Battling the Chargemaster: A Simple Remedy to Balance Billing for Unavoidable Out-of-Network Care |journal=The American Journal of Managed Care |date=28 April 2017 |volume=23 |issue=4 |access-date=12 March 2023 |last1=Richmond |first1=Barak D. |last2=Kitzman |first2=Nick |last3=Milstein |first3=Arnold |last4=Schulman |first4=Kevin A.}} Legislation requires hospitals to provide care to patients in life-threatening emergency situations regardless of the patient's ability to pay.{{cite web|date=26 March 2012|title=Emergency Medical Treatment & Labor Act (EMTALA)|url=http://www.cms.gov/Regulations-and-Guidance/Legislation/EMTALA/index.html?redirect=/emtala/|access-date=17 May 2013|publisher=[[Centers for Medicare & Medicaid Services]]}} Privately funded hospitals which admit uninsured patients in emergency situations incur direct financial losses, such as in the aftermath of [[Hurricane Katrina]].''[https://www.usatoday.com/money/industries/health/2006-04-25-new-orleans-hospitals-usat_x.htm Hospitals in New Orleans see surge in uninsured patients but not public funds]'' – ''[[USA Today]]'', Wednesday 26 April 2006 [149] => [150] => ==Quality and safety== [151] => As the quality of health care has increasingly become an issue around the world, hospitals have increasingly had to pay serious attention to this matter. Independent external assessment of quality is one of the most powerful ways to assess this aspect of health care, and [[hospital accreditation]] is one means by which this is achieved. In many parts of the world such accreditation is sourced from other countries, a phenomenon known as [[international healthcare accreditation]], by groups such as [[Accreditation Canada]] in [[Canada]], the [[Joint Commission]] in the U.S., the [[Trent Accreditation Scheme]] in [[Great Britain]], and the ''[[:fr:Haute Autorité de santé|Haute Autorité de santé]]'' (HAS) in [[France]]. In [[England]], hospitals are monitored by the [[Care Quality Commission]]. In 2020, they turned their attention to hospital food standards after seven patient deaths from [[listeria]] linked to pre-packaged sandwiches and salads in 2019, saying "Nutrition and hydration is part of a patient's recovery."{{cite news |title=CQC to inspect hospitals on food standards after patient deaths |url=https://www.hsj.co.uk/quality-and-performance/cqc-to-inspect-hospitals-on-food-standards-after-patient-deaths/7028974.article |access-date=24 December 2020 |publisher=Health Service Journal |date=17 November 2020}} [152] => [153] => The [[World Health Organization]] reported in 2011 that being admitted to a hospital was far riskier than flying. Globally, the chance of a patient being subject to a treatment error in a hospital was about 10%, and the chance of death resulting from an error was about one in 300. according to [[Liam Donaldson]]. 7% of hospitalised patients in developed countries, and 10% in developing countries, acquire at least one [[Hospital-acquired infection|health care-associated infection]]. In the U.S., 1.7 million infections are acquired in hospital each year, leading to 100,000 deaths, figures much worse than in Europe where there were 4.5 million infections and 37,000 deaths.{{cite news |title=Going into hospital far riskier than flying: WHO |url=https://www.reuters.com/article/us-safety/going-into-hospital-far-riskier-than-flying-who-idUSTRE76K45R20110721 |access-date=27 January 2019 |publisher=Reuters |date=21 July 2011}} [154] => [155] => ==Architecture== [156] => Modern hospital buildings are designed to minimise the effort of medical personnel and the possibility of contamination while maximising the efficiency of the whole system. Travel time for personnel within the hospital and the transportation of patients between units is facilitated and minimised. The building also should be built to accommodate heavy departments such as radiology and operating rooms while space for special wiring, plumbing, and waste disposal must be allowed for in the design.[[Annmarie Adams]], ''Medicine by Design: The Architect and the Modern Hospital, 1893–1943'' (2009) [157] => [158] => However, many hospitals, even those considered "modern", are the product of continual and often badly managed growth over decades or even centuries, with utilitarian new sections added on as needs and finances dictate. As a result, Dutch architectural historian Cor Wagenaar has called many hospitals: [159] => [160] => {{Blockquote|"... built catastrophes, anonymous institutional complexes run by vast bureaucracies, and totally unfit for the purpose they have been designed for ... They are hardly ever functional, and instead of making patients feel at home, they produce stress and anxiety."{{cite magazine |url=http://www.odemagazine.com/doc/35/healing_by_design |title=Healing by design |archive-url=https://web.archive.org/web/20071017220150/http://www.odemagazine.com/doc/35/healing_by_design |archive-date=17 October 2007 |url-status=dead |magazine=Ode |date=July–August 2006 |access-date=10 February 2008}}}} [161] => [162] => Some newer hospitals now try to re-establish design that takes the patient's psychological needs into account, such as providing more fresh air, better views and more pleasant colour schemes. These ideas harken back to the late eighteenth century, when the concept of providing fresh air and access to the 'healing powers of nature' were first employed by hospital architects in improving their buildings. [163] => [164] => The research of [[British Medical Association]] is showing that good hospital design can reduce patient's recovery time. Exposure to daylight is effective in reducing depression.{{Cite news |last=Yamaguchi |first=Yuhgo |date=5 October 2015 |title=Better Healing from Better Hospital Design |work=Harvard Business Review |url=https://hbr.org/2015/10/better-healing-from-better-hospital-design |access-date=30 August 2022 |issn=0017-8012}} Single-sex accommodation help ensure that patients are treated in privacy and with dignity. Exposure to nature and hospital gardens is also important – looking out windows improves patients' moods and reduces blood pressure and stress level. Open windows in patient rooms have also demonstrated some evidence of beneficial outcomes by improving airflow and increased microbial diversity.{{Cite news|url=https://www.theguardian.com/science/2012/feb/20/open-hospital-windows-stem-infections|title=Open hospital windows to stem spread of infections, says microbiologist|last=Sample|first=Ian|date=20 February 2012|journal=The Guardian|language=en|access-date=12 March 2018}}{{Cite news|url=https://www.bbc.com/news/health-22269698|title=Closed windows 'increase infection'|last=Bowdler|first=Neil|date=26 April 2013|work=BBC News|access-date=12 March 2018|language=en-GB}} Eliminating long corridors can reduce nurses' fatigue and stress.{{cite web|title=The psychological and social needs of patients |url=http://www.bma.org.uk/health_promotion_ethics/psychologicalandsocialneedsofpatients.jsp?page=8 |publisher=[[British Medical Association]] |access-date=14 March 2011 |date=7 January 2011 |url-status=dead |archive-url=https://web.archive.org/web/20110314184736/http://www.bma.org.uk/health_promotion_ethics/psychologicalandsocialneedsofpatients.jsp?page=8 |archive-date=14 March 2011 }} [165] => [166] => Another ongoing major development is the change from a ward-based system (where patients are accommodated in communal rooms, separated by movable partitions) to one in which they are accommodated in individual rooms. The ward-based system has been described as very efficient, especially for the medical staff, but is considered to be more stressful for patients and detrimental to their privacy. A major constraint on providing all patients with their own rooms is however found in the higher cost of building and operating such a hospital; this causes some hospitals to charge for private rooms.{{cite web |url-status=live |url=http://www.nationalreviewofmedicine.com/issue/2004/11_15/feature05_21.html |title=Health administrators go shopping for new hospital designs |archive-url=https://web.archive.org/web/20081226075348/http://www.nationalreviewofmedicine.com/issue/2004/11_15/feature05_21.html|archive-date=26 December 2008 |website=[[National Review of Medicine]] |date=15 November 2004 |series=Volume 1, no. 21 |first1=Julian |last1=Rosenberg }} [167] => [168] => [169] => File:UVa Medical Center.jpg|upright=0.8|The medical center at the [[University of Virginia]] shows the growing trend for modern architecture in hospitals. [170] => File:NHS NNUH entrance.jpg|upright=0.8|The [[National Health Service]] [[Norfolk and Norwich University Hospital]] in the UK, showing the utilitarian architecture of many modern hospitals [171] => File:Fawcett Memorial Hospital Chapel.jpg|upright=0.8|Hospital chapel at [[Fawcett Memorial Hospital]] ([[Port Charlotte, Florida]]) [172] => File:Hinduja Hospital, Mahim, Mumbai.jpg|upright=0.8|[[Hinduja National Hospital|Hinduja National Hospital, Mumbai]] [173] => File:Intensivstation (01) 2007-03-03.jpg|upright=0.8|An [[intensive care unit]] (ICU) within a hospital [174] => File:KlinikumAachen.jpg|upright=0.8|[[Uniklinikum Aachen]] in Germany [175] => File:TAYS,TAMPERE 1.12-09 aamulla n.klo 8 - panoramio.jpg|upright=0.8|[[Tampere University Hospital]] in [[Tampere]], Finland [176] => File:AIIMS central lawn.jpg|upright=0.8|[[AIIMS, New Delhi|All India Institute of Medical Sciences]] in Delhi, India [177] => File:Lehigh-Valley-Hospital.x.jpg|upright=0.8|[[Lehigh Valley Hospital–Cedar Crest]] in [[Allentown, Pennsylvania]], U.S. [178] => [179] => [180] => ==See also== [181] => * [[Burn center]] [182] => * [[History of hospitals]] [183] => * [[History of medicine]] [184] => * [[Hospice]] [185] => * [[Hospital network]] [186] => * [[Lists of hospitals]] [187] => * [[Hospital information system]] [188] => * [[Trauma center]] [189] => * ''[[The Waiting Room (2012 film)|The Waiting Room]]'' [190] => * [[Walk-in clinic]] [191] => [192] => ==Notes== [193] => {{notelist}} [194] => [195] => ==References== [196] => {{reflist}} [197] => [198] => ==Bibliography== [199] => ===History of hospitals=== [200] => * Brockliss, Lawrence, and Colin Jones. "The Hospital in the Enlightenment", in ''The Medical World of Early Modern France'' (Oxford UP, 1997), pp. 671–729; covers France 1650–1800 [201] => * Chaney, Edward (2000), [https://books.google.com/books/about/The_evolution_of_the_grand_tour.html?id=rYB_HYPsa8gC {{" '}}Philanthropy in Italy': English Observations on Italian Hospitals 1545–1789"], in: ''The Evolution of the Grand Tour: Anglo-Italian Cultural Relations since the Renaissance'', 2nd ed. London, Routledge, 2000. [202] => * Connor, J.T.H. "Hospital History in Canada and the United States", ''Canadian Bulletin of Medical History'', 1990, Vol. 7 Issue 1, pp. 93–104 [203] => * Crawford, D.S. Bibliography of Histories of Canadian hospitals and schools of nursing. [204] => * Gorsky, Martin. "The British National Health Service 1948–2008: A Review of the Historiography", ''Social History of Medicine'', December 2008, Vol. 21 Issue 3, pp. 437–60 [205] => * Harrison, Mar, et al. eds. ''From Western Medicine to Global Medicine: The Hospital Beyond the West'' (2008) [206] => * Horden, Peregrine. ''Hospitals and Healing From Antiquity to the Later Middle Ages'' (2008) [207] => * McGrew, Roderick E. ''Encyclopedia of Medical History'' (1985) [208] => * {{Citation [209] => |last1=Morelon [210] => |first1=Régis [211] => |last2=Rashed [212] => |first2=Roshdi [213] => |year=1996 [214] => |title=Encyclopedia of the History of Arabic Science [215] => |volume=3 [216] => |publisher=Routledge [217] => |isbn=978-0-415-12410-2 [218] => }} [219] => * Porter, Roy. ''The Hospital in History'', with Lindsay Patricia Granshaw (1989) {{ISBN|978-0-415-00375-9}} [220] => * [[Guenter B. Risse|Risse, Guenter B.]] ''Mending Bodies, Saving Souls: A History of Hospitals'' (1999); world coverage [221] => * Rosenberg, Charles E. ''The Care of Strangers: The Rise of America's Hospital System'' (1995); history to 1920 [222] => * Scheutz, Martin et al. eds. ''Hospitals and Institutional Care in Medieval and Early Modern Europe'' (2009) [223] => * Wall, Barbra Mann. ''American Catholic Hospitals: A Century of Changing Markets and Missions'' (Rutgers University Press, 2011). {{ISBN|978-0-8135-4940-8}} [224] => [225] => ==External links== [226] => {{wiktionary|hospital}} [227] => {{commons}} [228] => * [[WHO]] Hospitals https://www.who.int/hospitals/en/ [229] => * {{cite web|url= https://us.hospitalsworldguide.com/hospitals-in-usa/|title= Global and Multilanguage Database of public and private hospitals|website= hospitalsworldguide[[.com]]|language= en}} [230] => * {{cite web|url= http://hospitals.webometrics.info/|title= Directory and Ranking of more than 17.000 Hospitals worldwide|website= hospitals.webometrics.info|language= en|access-date= 7 November 2008|archive-date= 21 April 2010|archive-url= https://web.archive.org/web/20100421162908/http://hospitals.webometrics.info/|url-status= dead}} [231] => [232] => {{Portal bar|Medicine|Engineering}} [233] => [234] => {{Hospital articles}} [235] => {{Health care}} [236] => {{Public infrastructure topics}} [237] => {{Authority control}} [238] => [239] => [[Category:Hospitals| ]] [] => )
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Hospital

A hospital is a healthcare institution that provides medical and surgical treatment to patients. It is typically equipped with specialized medical equipment and staffed by trained healthcare professionals, including doctors, nurses, and various other support staff.

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It is typically equipped with specialized medical equipment and staffed by trained healthcare professionals, including doctors, nurses, and various other support staff. Hospitals play a critical role in providing healthcare services, such as diagnosing and treating illnesses, performing surgeries, and providing emergency care. They also often function as educational and research institutions, where medical students and healthcare professionals receive training and conduct research. The history of hospitals dates back to ancient times, with the earliest known institutions established in ancient Egypt and Greece. However, the modern concept of hospitals emerged in the 18th and 19th centuries, with the development of systematic medical education and advancements in medical science. Hospitals can vary in size and specialization, ranging from small community clinics to large medical centers with advanced facilities and specialized departments. They may cater to general healthcare needs or focus on specific areas such as pediatrics, oncology, neurology, or cardiology. In addition to providing medical care, hospitals often offer ancillary services such as pharmacy, laboratory testing, imaging, rehabilitation, and counseling. They also form an integral part of a healthcare system, collaborating with other healthcare providers, such as primary care clinics and specialty hospitals, to ensure coordinated and comprehensive patient care. While hospitals are essential in providing healthcare, they also face challenges such as the rising costs of medical services, scarcity of healthcare professionals, and the need to adapt to technological advancements. Efforts are being made to improve accessibility, affordability, and quality of care through initiatives like telemedicine, electronic health records, and hospital management systems. Overall, hospitals are vital institutions in maintaining the health and well-being of individuals and societies. They continue to evolve and adapt to the changing healthcare landscape, striving to provide effective and compassionate care to all patients.

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