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A hospital is a
health care Health care or healthcare is the improvement of health via the prevention, diagnosis, treatment, amelioration or cure of disease, illness, injury, and other physical and mental impairments in people. Health care is delivered by health profe ...
institution providing
patient A patient is any recipient of health care services that are performed by healthcare professionals. The patient is most often ill or injured and in need of treatment by a physician, nurse, optometrist, dentist, veterinarian, or other health c ...
treatment with specialized
health science The following outline is provided as an overview of and topical guide to health sciences: Health sciences are those sciences which focus on health, or health care, as core parts of their subject matter. Health sciences relate to multiple acad ...
and auxiliary healthcare staff and medical equipment. The best-known type of hospital is the general hospital, which typically has an
emergency department An emergency department (ED), also known as an accident and emergency department (A&E), emergency room (ER), emergency ward (EW) or casualty department, is a medical treatment facility specializing in emergency medicine, the acute care of pati ...
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 Intensive care medicine, also called critical care medicine, is a medical specialty that deals with seriously or critically ill patients who have, are at risk of, or are recovering from conditions that may be life-threatening. It includes pro ...
and additional beds for patients who need long-term care. Specialized hospitals include
trauma center A trauma center (or trauma centre) is a hospital equipped and staffed to provide care for patients suffering from major trauma, major traumatic injuries such as Falling (accident), falls, motor vehicle collisions, or gunshot wounds. A trauma cent ...
s,
rehabilitation hospital Rehabilitation hospitals, also referred to as inpatient rehabilitation hospitals, are devoted to the rehabilitation of patients with various neurological, musculoskeletal, orthopedic, and other medical conditions following stabilization of their acu ...
s,
children's hospital A children's hospital is a hospital that offers its services exclusively to infants, children, adolescents, and young adults. In certain special cases, they may also treat adults. The number of children's hospitals proliferated in the 20th ...
s, seniors' (
geriatric Geriatrics, or geriatric medicine, is a medical specialty focused on providing care for the unique health needs of older adults. The term ''geriatrics'' originates from the Greek language, Greek γέρων ''geron'' meaning "old man", and ιατ ...
) hospitals, and hospitals for dealing with specific medical needs such as
psychiatric Psychiatry is the medical specialty devoted to the diagnosis, prevention, and treatment of mental disorders. These include various maladaptations related to mood, behaviour, cognition, and perceptions. See glossary of psychiatry. Initial psy ...
treatment (see
psychiatric hospital Psychiatric hospitals, also known as mental health hospitals, behavioral health hospitals, are hospitals or wards specializing in the treatment of severe mental disorders, such as schizophrenia, bipolar disorder, eating disorders, dissociative ...
) and certain disease categories. Specialized hospitals can help reduce
health care costs Health, according to the World Health Organization, is "a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity".World Health Organization. (2006)''Constitution of the World Health Organiza ...
compared to general hospitals. Hospitals are classified as general, specialty, or government depending on the sources of income received. A
teaching hospital A teaching hospital is a hospital or medical centre that provides medical education and training to future and current health professionals. Teaching hospitals are almost always affiliated with one or more universities and are often co-located ...
combines assistance to people with teaching to
health science The following outline is provided as an overview of and topical guide to health sciences: Health sciences are those sciences which focus on health, or health care, as core parts of their subject matter. Health sciences relate to multiple acad ...
students and auxiliary healthcare students. A health science facility smaller than a hospital is generally called a
clinic A clinic (or outpatient clinic or ambulatory care clinic) is a health facility that is primarily focused on the care of outpatients. Clinics can be privately operated or publicly managed and funded. They typically cover the primary care needs ...
. Hospitals have a range of departments (e.g.
surgery Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pat ...
and
urgent care An urgent care center (UCC), also known as an urgent treatment centre in the United Kingdom, is a type of walk-in clinic focused on the delivery of urgent ambulatory care in a dedicated medical facility outside of a traditional emergency department ...
) and specialist units such as
cardiology Cardiology () is a branch of medicine that deals with disorders of the heart and the cardiovascular system. The field includes medical diagnosis and treatment of congenital heart defects, coronary artery disease, heart failure, valvular heart d ...
. Some hospitals have outpatient departments and some have chronic treatment units. Common support units include a
pharmacy Pharmacy is the science and practice of discovering, producing, preparing, dispensing, reviewing and monitoring medications, aiming to ensure the safe, effective, and affordable use of medicines. It is a miscellaneous science as it links heal ...
,
pathology Pathology is the study of the causes and effects of disease or injury. The word ''pathology'' also refers to the study of disease in general, incorporating a wide range of biology research fields and medical practices. However, when used in ...
, and
radiology Radiology ( ) is the medical discipline that uses medical imaging to diagnose diseases and guide their treatment, within the bodies of humans and other animals. It began with radiography (which is why its name has a root referring to radiat ...
. Hospitals are typically funded by
public funding A subsidy or government incentive is a form of financial aid or support extended to an economic sector (business, or individual) generally with the aim of promoting economic and social policy. Although commonly extended from the government, the ter ...
, health organisations ( for-profit or
nonprofit A nonprofit organization (NPO) or non-profit organisation, also known as a non-business entity, not-for-profit organization, or nonprofit institution, is a legal entity organized and operated for a collective, public or social benefit, in co ...
),
health insurance Health insurance or medical insurance (also known as medical aid in South Africa) is a type of insurance that covers the whole or a part of the risk of a person incurring medical expenses. As with other types of insurance, risk is shared among ma ...
companies, or
charities A charitable organization or charity is an organization whose primary objectives are philanthropy and social well-being (e.g. educational, religious or other activities serving the public interest or common good). The legal definition of a cha ...
, including direct charitable donations. Historically, hospitals were often founded and funded by
religious orders A religious order is a lineage of communities and organizations of people who live in some way set apart from society in accordance with their specific religious devotion, usually characterized by the principles of its founder's religious practi ...
, or by charitable individuals and leaders. Currently, hospitals are largely staffed by professional
physician A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...
s,
surgeon In modern medicine, a surgeon is a medical professional who performs surgery. Although there are different traditions in different times and places, a modern surgeon usually is also a licensed physician or received the same medical training as ...
s,
nurse Nursing is a profession within the health care sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other health c ...
s, and allied health practitioners, whereas in the past, this work was usually performed by the members of founding religious orders or by
volunteers Volunteering is a voluntary act of an individual or group freely giving time and labor for community service. Many volunteers are specifically trained in the areas they work, such as medicine, education, or emergency rescue. Others serve ...
. However, there are various Catholic religious orders, such as the
Alexians The Alexians officially named as the Congregation of Alexian Brothers ( la, Congregatio Fratrum Cellitarum seu Alexianorum) abbreviated C.F.A., is a Catholic lay religious congregation of Pontifical Right for men specifically devoted to caring ...
and the
Bon Secours Sisters The Congregation of the Sisters of Bon Secours is an international Roman Catholic women's religious congregation for nursing (''gardes malades''), whose declared mission is to care for those who are sick and dying. It was founded by Josephine Pot ...
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. 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 The Royal Hospital Chelsea is a retirement home and nursing home for some 300 veterans of the British Army. Founded as an almshouse, the ancient sense of the word "hospital", it is a site located on Royal Hospital Road in Chelsea. It is an ...
, established in 1681 as a retirement and nursing home for veteran soldiers.


Etymology

During the Middle Ages, hospitals served different functions from modern institutions in that they were
almshouses An almshouse (also known as a bede-house, poorhouse, or hospital) was charitable housing provided to people in a particular community, especially during the medieval era. They were often targeted at the poor of a locality, at those from certain ...
for the poor,
hostel A hostel is a form of low-cost, short-term shared sociable lodging where guests can rent a bed, usually a bunk bed in a dormitory, with shared use of a lounge and sometimes a kitchen. Rooms can be mixed or single-sex and have private or shared b ...
s for pilgrims, or hospital schools. The word "hospital" comes from the
Latin Latin (, or , ) is a classical language belonging to the Italic branch of the Indo-European languages. Latin was originally a dialect spoken in the lower Tiber area (then known as Latium) around present-day Rome, but through the power of the ...
, signifying a stranger or foreigner, hence a guest. Another noun derived from this, came to signify hospitality, that is the relation between guest and shelterer, hospitality, friendliness, and hospitable reception. By
metonymy Metonymy () is a figure of speech in which a concept is referred to by the name of something closely associated with that thing or concept. Etymology The words ''metonymy'' and ''metonym'' come from grc, μετωνυμία, 'a change of name' ...
, the Latin word then came to mean a guest-chamber, guest's lodging, an
inn Inns are generally establishments or buildings where travelers can seek lodging, and usually, food and drink. Inns are typically located in the country or along a highway; before the advent of motorized transportation they also provided accommo ...
. is thus the root for the English words ''host'' (where the ''p'' was dropped for convenience of pronunciation) ''
hospitality Hospitality is the relationship between a guest and a host, wherein the host receives the guest with some amount of goodwill, including the reception and entertainment of guests, visitors, or strangers. Louis de Jaucourt, Louis, chevalier de J ...
'', ''
hospice Hospice care is a type of health care that focuses on the palliation of a terminally ill patient's pain and symptoms and attending to their emotional and spiritual needs at the end of life. Hospice care prioritizes comfort and quality of life by ...
'', ''
hostel A hostel is a form of low-cost, short-term shared sociable lodging where guests can rent a bed, usually a bunk bed in a dormitory, with shared use of a lounge and sometimes a kitchen. Rooms can be mixed or single-sex and have private or shared b ...
,'' and ''
hotel A hotel is an establishment that provides paid lodging on a short-term basis. Facilities provided inside a hotel room may range from a modest-quality mattress in a small room to large suites with bigger, higher-quality beds, a dresser, a ref ...
''. The latter modern word derives from Latin via the
Old French Old French (, , ; Modern French: ) was the language spoken in most of the northern half of France from approximately the 8th to the 14th centuries. Rather than a unified language, Old French was a linkage of Romance dialects, mutually intelligib ...
romance word , which developed a silent ''s'', which letter was eventually removed from the word, the loss of which is signified by a
circumflex The circumflex () is a diacritic in the Latin and Greek scripts that is also used in the written forms of many languages and in various romanization and transcription schemes. It received its English name from la, circumflexus "bent around"a ...
in the
modern French French ( or ) is a Romance language of the Indo-European family. It descended from the Vulgar Latin of the Roman Empire, as did all Romance languages. French evolved from Gallo-Romance, the Latin spoken in Gaul, and more specifically in No ...
word . The
German German(s) may refer to: * Germany (of or related to) **Germania (historical use) * Germans, citizens of Germany, people of German ancestry, or native speakers of the German language ** For citizens of Germany, see also German nationality law **Ger ...
word shares similar roots.


Types

Some
patient A patient is any recipient of health care services that are performed by healthcare professionals. The patient is most often ill or injured and in need of treatment by a physician, nurse, optometrist, dentist, veterinarian, or other health c ...
s go to a hospital just for
diagnosis Diagnosis is the identification of the nature and cause of a certain phenomenon. Diagnosis is used in many different disciplines, with variations in the use of logic, analytics, and experience, to determine " cause and effect". In systems engin ...
, treatment, or therapy and then leave ("
outpatients A patient is any recipient of health care services that are performed by healthcare professionals. The patient is most often ill or injured and in need of treatment by a physician, nurse, optometrist, dentist, veterinarian, or other health ca ...
") without staying overnight; while others are "admitted" and stay overnight or for several days or weeks or months ("
inpatients A patient is any recipient of health care services that are performed by healthcare professionals. The patient is most often ill or injured and in need of treatment by a physician, nurse, optometrist, dentist, veterinarian, or other health car ...
"). 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 A clinic (or outpatient clinic or ambulatory care clinic) is a health facility that is primarily focused on the care of outpatients. Clinics can be privately operated or publicly managed and funded. They typically cover the primary care needs ...
.


General and acute care

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 A trauma center (or trauma centre) is a hospital equipped and staffed to provide care for patients suffering from major trauma, major traumatic injuries such as Falling (accident), falls, motor vehicle collisions, or gunshot wounds. A trauma cent ...
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.


District

A district hospital typically is the major health care facility in its region, with large numbers of beds for
intensive care Intensive care medicine, also called critical care medicine, is a medical specialty that deals with seriously or critically ill patients who have, are at risk of, or are recovering from conditions that may be life-threatening. It includes pro ...
, critical care, and long-term care. In
California California is a U.S. state, state in the Western United States, located along the West Coast of the United States, Pacific Coast. With nearly 39.2million residents across a total area of approximately , it is the List of states and territori ...
, "district hospital" refers specifically to a class of healthcare facility created shortly after
World War II World War II or the Second World War, often abbreviated as WWII or WW2, was a world war that lasted from 1939 to 1945. It involved the vast majority of the world's countries—including all of the great powers—forming two opposin ...
to address a shortage of hospital beds in many local communities. 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 The California Medical Assistance Program (Medi-Cal or MediCal) is California's Medicaid program serving low-income individuals, including families, seniors, persons with disabilities, children in foster care, pregnant women, and childless adults wi ...
(which is California's
Medicaid Medicaid in the United States is a federal and state program that helps with healthcare costs for some people with limited income and resources. Medicaid also offers benefits not normally covered by Medicare, including nursing home care and pers ...
program, serving low-income persons, some
senior citizens Old age refers to ages nearing or surpassing the life expectancy of human beings, and is thus the end of the human biological life cycle, life cycle. Terms and euphemisms for people at this age include old people, the elderly (worldwide usage ...
, persons with
disabilities Disability is the experience of any condition that makes it more difficult for a person to do certain activities or have equitable access within a given society. Disabilities may be cognitive, developmental, intellectual, mental, physical, se ...
, children in
foster care Foster care is a system in which a minor has been placed into a ward, group home (residential child care community, treatment center, etc.), or private home of a state-certified caregiver, referred to as a "foster parent" or with a family mem ...
, and pregnant women). In 2012, district hospitals provided $54 million in uncompensated care in California.


Specialized

A specialty hospital is primarily and exclusively dedicated to one or a few related
medical specialties A medical specialty is a branch of medical practice that is focused on a defined group of patients, diseases, skills, or philosophy. Examples include those branches of medicine that deal exclusively with children (paediatrics), cancer (oncology), ...
. Subtypes include
rehabilitation hospital Rehabilitation hospitals, also referred to as inpatient rehabilitation hospitals, are devoted to the rehabilitation of patients with various neurological, musculoskeletal, orthopedic, and other medical conditions following stabilization of their acu ...
s,
children's hospital A children's hospital is a hospital that offers its services exclusively to infants, children, adolescents, and young adults. In certain special cases, they may also treat adults. The number of children's hospitals proliferated in the 20th ...
s, seniors' (
geriatric Geriatrics, or geriatric medicine, is a medical specialty focused on providing care for the unique health needs of older adults. The term ''geriatrics'' originates from the Greek language, Greek γέρων ''geron'' meaning "old man", and ιατ ...
) hospitals, long-term acute care facilities, and hospitals for dealing with specific medical needs such as
psychiatric Psychiatry is the medical specialty devoted to the diagnosis, prevention, and treatment of mental disorders. These include various maladaptations related to mood, behaviour, cognition, and perceptions. See glossary of psychiatry. Initial psy ...
problems (see
psychiatric hospital Psychiatric hospitals, also known as mental health hospitals, behavioral health hospitals, are hospitals or wards specializing in the treatment of severe mental disorders, such as schizophrenia, bipolar disorder, eating disorders, dissociative ...
),
cancer treatment Cancer can be treated by surgery, chemotherapy, radiation therapy, hormonal therapy, targeted therapy (including immunotherapy such as monoclonal antibody therapy) and synthetic lethality, most commonly as a series of separate treatments (e.g. ...
, certain disease categories such as cardiac, oncology, or orthopedic problems, and so forth. In Germany specialised hospitals are called ''Fachkrankenhaus''; an example is
Fachkrankenhaus Coswig The Fachkrankenhaus Coswig (FKC) hospital is a clinic specializing in the treatment of bronchial and pulmonary diseases. In 2018, a total of approx. 8,000 patients were treated in the FKC hospital which has 171 beds. Fachkrankenhaus Coswig T ...
(thoracic surgery). In India, specialty hospitals are known as ''super-specialty hospitals'' and are distinguished from multispecialty hospitals which are composed of several specialties. Specialised hospitals can help reduce
health care costs Health, according to the World Health Organization, is "a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity".World Health Organization. (2006)''Constitution of the World Health Organiza ...
compared to general hospitals. For example, Narayana Health's cardiac unit in
Bangalore Bangalore (), officially Bengaluru (), is the capital and largest city of the Indian state of Karnataka. It has a population of more than and a metropolitan population of around , making it the third most populous city and fifth most ...
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. 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 In microeconomics, economies of scale are the cost advantages that enterprises obtain due to their scale of operation, and are typically measured by the amount of output produced per unit of time. A decrease in cost per unit of output enables ...
and reduce its cost per procedure. Each specialist may also become more efficient by working on one procedure like a
production line A production line is a set of sequential operations established in a factory where components are assembled to make a finished article or where materials are put through a refining process to produce an end-product that is suitable for onward c ...
.


Teaching

A
teaching hospital A teaching hospital is a hospital or medical centre that provides medical education and training to future and current health professionals. Teaching hospitals are almost always affiliated with one or more universities and are often co-located ...
delivers healthcare to patients as well as training to prospective
medical professionals A health professional, healthcare professional, or healthcare worker (sometimes abbreviated HCW) is a provider of health care treatment and advice based on formal training and experience. The field includes those who work as a nurse, physician (su ...
such as
medical students A medical school is a tertiary educational institution, or part of such an institution, that teaches medicine, and awards a professional degree for physicians. Such medical degrees include the Bachelor of Medicine, Bachelor of Surgery (MBBS, MB ...
and student
nurses Nursing is a profession within the health care sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other health ca ...
. It may be linked to a
medical school A medical school is a tertiary educational institution, or part of such an institution, that teaches medicine, and awards a professional degree for physicians. Such medical degrees include the Bachelor of Medicine, Bachelor of Surgery (MBBS, M ...
or
nursing school Nursing is a profession within the health care sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other health ca ...
, and may be involved in
medical research Medical research (or biomedical research), also known as experimental medicine, encompasses a wide array of research, extending from "basic research" (also called ''bench science'' or ''bench research''), – involving fundamental scientif ...
. Students may also observe clinical work in the hospital.


Clinics

Clinics A clinic (or outpatient clinic or ambulatory care clinic) is a health facility that is primarily focused on the care of outpatients. Clinics can be privately operated or publicly managed and funded. They typically cover the primary care needs ...
generally provide only
outpatient A patient is any recipient of health care services that are performed by healthcare professionals. The patient is most often ill or injured and in need of treatment by a physician, nurse, optometrist, dentist, veterinarian, or other health care ...
services, but some may have a few inpatient beds and a limited range of services that may otherwise be found in typical hospitals.


Departments or wards

A hospital contains one or more wards that house
hospital bed A hospital bed or hospital cot is a bed specially designed for hospitalized patients or others in need of some form of health care. These beds have special features both for the comfort and well-being of the patient and for the convenience of he ...
s for
inpatient A patient is any recipient of health care services that are performed by healthcare professionals. The patient is most often ill or injured and in need of treatment by a physician, nurse, optometrist, dentist, veterinarian, or other health ca ...
s. It may also have acute services such as an
emergency department An emergency department (ED), also known as an accident and emergency department (A&E), emergency room (ER), emergency ward (EW) or casualty department, is a medical treatment facility specializing in emergency medicine, the acute care of pati ...
,
operating theatre An operating theater (also known as an operating room (OR), operating suite, or operation suite) is a facility within a hospital where surgical operations are carried out in an aseptic environment. Historically, the term "operating theater" refe ...
, and
intensive care unit 220px, Intensive care unit An intensive care unit (ICU), also known as an intensive therapy unit or intensive treatment unit (ITU) or critical care unit (CCU), is a special department of a hospital or health care facility that provides intensiv ...
, as well as a range of
medical specialty A medical specialty is a branch of medical practice that is focused on a defined group of patients, diseases, skills, or philosophy. Examples include those branches of medicine that deal exclusively with children (paediatrics), cancer (oncology), ...
departments. A well-equipped hospital may be classified as a
trauma center A trauma center (or trauma centre) is a hospital equipped and staffed to provide care for patients suffering from major trauma, major traumatic injuries such as Falling (accident), falls, motor vehicle collisions, or gunshot wounds. A trauma cent ...
. They may also have other services such as a
hospital pharmacy A hospital pharmacy is a department within a hospital that prepares, compounds, stocks and dispenses inpatient medications. Hospital pharmacies usually stock a larger range of medications, including more specialized and investigational medicatio ...
,
radiology Radiology ( ) is the medical discipline that uses medical imaging to diagnose diseases and guide their treatment, within the bodies of humans and other animals. It began with radiography (which is why its name has a root referring to radiat ...
,
pathology Pathology is the study of the causes and effects of disease or injury. The word ''pathology'' also refers to the study of disease in general, incorporating a wide range of biology research fields and medical practices. However, when used in ...
, and
medical laboratories A medical laboratory or clinical laboratory is a laboratory where tests are conducted out on clinical specimens to obtain information about the health of a patient to aid in diagnosis, treatment, and prevention of disease. Clinical Medical labor ...
. Some hospitals have outpatient departments such as
behavioral health Mental health encompasses emotional, psychological, and social well-being, influencing cognition, perception, and behavior. It likewise determines how an individual handles stress, interpersonal relationships, and decision-making. Mental health ...
services,
dentistry Dentistry, also known as dental medicine and oral medicine, is the branch of medicine focused on the teeth, gums, and mouth. It consists of the study, diagnosis, prevention, management, and treatment of diseases, disorders, and conditions o ...
, and
rehabilitation services Physical medicine and rehabilitation, also known as physiatry, is a branch of medicine that aims to enhance and restore functional ability and quality of life to people with physical impairments or disabilities. This can include conditions su ...
. A hospital may also have a department of nursing, headed by a
chief nursing officer Nursing management consists of the performance of the leadership functions of governance and decision-making within organizations employing nurses. It includes processes common to all management like planning, organizing, staffing, directing and ...
or director of nursing. This department is responsible for the administration of professional nursing practice,
research Research is "creativity, creative and systematic work undertaken to increase the stock of knowledge". It involves the collection, organization and analysis of evidence to increase understanding of a topic, characterized by a particular att ...
, and policy for the hospital. 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. Support units may include a
medical records department Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care practic ...
,
release of information department A release of information (ROI) department or division is found in the majority of hospitals. In the United States, HIPAA and state guidelines strongly direct the rules and regulations of patient information. ROI departments perform such tasks as o ...
,
technical support Technical support (abbreviated as tech support) is a call centre type customer service provided by companies to advise and assist registered users with issues concerning their technical products. Traditionally done on the phone, technical suppor ...
,
clinical engineering Clinical engineering is a specialty within biomedical engineering responsible for using medical technology to optimize healthcare delivery. Clinical engineers train and supervise biomedical equipment technicians (BMETs), working with governm ...
, facilities management,
plant operations Physical plant, mechanical plant or industrial plant (and where context is given, often just plant) refers to the necessary infrastructure used in operation and maintenance of a given facility. The operation of these facilities, or the department o ...
, dining services, and security departments.


Remote monitoring

The
COVID-19 pandemic The COVID-19 pandemic, also known as the coronavirus pandemic, is an ongoing global pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The novel virus was first identif ...
stimulated the development of virtual wards across the British
NHS The National Health Service (NHS) is the umbrella term for the publicly funded healthcare systems of the United Kingdom (UK). Since 1948, they have been funded out of general taxation. There are three systems which are referred to using the " ...
. 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 West Hertfordshire Teaching Hospitals NHS Trust runs three National Health Services hospitals: Watford General Hospital, St Albans City Hospital and Hemel Hempstead Hospital, in Hertfordshire, England. It provides "acute healthcare services t ...
managed around 1200 patients at home between March and June 2020 and planned to continue the system after COVID-19, initially for respiratory patients.
Mersey Care NHS Foundation Trust Mersey Care NHS Foundation Trust runs a specialist mental health trust and provides learning disabilities, addiction management, acquired brain injury services and the provision of community nursing and therapies services in The City of Liver ...
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.


History


Early examples

In early India,
Fa Xian Faxian (法顯 ; 337 CE – c. 422 CE), also referred to as Fa-Hien, Fa-hsien and Sehi, was a Chinese Buddhist monk and translator who traveled by foot from China to India to acquire Buddhist texts. Starting his arduous journey about age 60, he ...
, a Chinese Buddhist monk who travelled across India c. AD 400, recorded examples of healing institutions. According to the '' Mahavamsa'', the ancient chronicle of Sinhalese royalty, written in the sixth century AD, King
Pandukabhaya of Sri Lanka Pandukabhaya (474 BC – 367 BC) was King of Kingdom of Upatissa Nuwara, Upatissa Nuwara and the first monarch of the Anuradhapura Kingdom and 6th over all of the island of Sri Lanka since the arrival of the Vijaya of Sri Lanka, Vijaya; he reign ...
(r. 437–367 BC) had lying-in-homes and hospitals (Sivikasotthi-Sala). A hospital and medical training centre also existed at
Gundeshapur Gundeshapur ( pal, 𐭥𐭧𐭩𐭠𐭭𐭣𐭩𐭥𐭪𐭱𐭧𐭯𐭥𐭧𐭥𐭩, ''Weh-Andiōk-Šābuhr''; New Persian: , ''Gondēshāpūr'') was the intellectual centre of the Sassanid Empire and the home of the Academy of Gundishapur, founde ...
, a major city in southwest of the
Sassanid Persian Empire The Sasanian () or Sassanid Empire, officially known as the Empire of Iranians (, ) and also referred to by historians as the Neo-Persian Empire, was the last Iranian empire before the early Muslim conquests of the 7th-8th centuries AD. Named ...
founded in AD 271 by
Shapur I Shapur I (also spelled Shabuhr I; pal, 𐭱𐭧𐭯𐭥𐭧𐭥𐭩, Šābuhr ) was the second Sasanian King of Kings of Iran. The dating of his reign is disputed, but it is generally agreed that he ruled from 240 to 270, with his father Ardas ...
. In
ancient Greece Ancient Greece ( el, Ἑλλάς, Hellás) was a northeastern Mediterranean civilization, existing from the Greek Dark Ages of the 12th–9th centuries BC to the end of classical antiquity ( AD 600), that comprised a loose collection of cult ...
, temples dedicated to the healer-god
Asclepius Asclepius (; grc-gre, Ἀσκληπιός ''Asklēpiós'' ; la, Aesculapius) is a hero and god of medicine in ancient Religion in ancient Greece, Greek religion and Greek mythology, mythology. He is the son of Apollo and Coronis (lover of ...
, known as
Asclepeion Asclepieia ( grc, Ἀσκληπιεῖον ''Asklepieion''; Ἀσκλαπιεῖον in Doric dialect; Latin ''aesculapīum'') were healing temples located in ancient Greece (and in the wider Hellenistic and Roman world), dedicated to Asclepius ...
functioned as centres of medical advice, prognosis, and healing. The Asclepeia spread to the
Roman Empire The Roman Empire ( la, Imperium Romanum ; grc-gre, Βασιλεία τῶν Ῥωμαίων, Basileía tôn Rhōmaíōn) was the post-Republican period of ancient Rome. As a polity, it included large territorial holdings around the Mediterr ...
. 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.


Middle Ages

The declaration of
Christianity Christianity is an Abrahamic monotheistic religion based on the life and teachings of Jesus of Nazareth. It is the world's largest and most widespread religion with roughly 2.38 billion followers representing one-third of the global pop ...
as an accepted religion in the Roman Empire drove an expansion of the provision of care. Following the
First Council of Nicaea The First Council of Nicaea (; grc, Νίκαια ) was a council of Christian bishops convened in the Bithynian city of Nicaea (now İznik, Turkey) by the Roman Emperor Constantine I in AD 325. This ecumenical council was the first effort ...
in AD 325 construction of a hospital in every
cathedral A cathedral is a church that contains the '' cathedra'' () of a bishop, thus serving as the central church of a diocese, conference, or episcopate. Churches with the function of "cathedral" are usually specific to those Christian denomination ...
town was begun, including among the earliest hospitals by Saint Sampson in
Constantinople la, Constantinopolis ota, قسطنطينيه , alternate_name = Byzantion (earlier Greek name), Nova Roma ("New Rome"), Miklagard/Miklagarth (Old Norse), Tsargrad ( Slavic), Qustantiniya (Arabic), Basileuousa ("Queen of Cities"), Megalopolis (" ...
and by Basil, bishop of Caesarea in modern-day Turkey. 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. The earliest general hospital in the Islamic world was built in 805 in
Baghdad Baghdad (; ar, بَغْدَاد , ) is the capital of Iraq and the second-largest city in the Arab world after Cairo. It is located on the Tigris near the ruins of the ancient city of Babylon and the Sassanid Persian capital of Ctesiphon ...
by
Harun Al-Rashid Abu Ja'far Harun ibn Muhammad al-Mahdi ( ar , أبو جعفر هارون ابن محمد المهدي) or Harun ibn al-Mahdi (; or 766 – 24 March 809), famously known as Harun al-Rashid ( ar, هَارُون الرَشِيد, translit=Hārūn ...
. By the 10th century, Baghdad had five more hospitals, while
Damascus )), is an adjective which means "spacious". , motto = , image_flag = Flag of Damascus.svg , image_seal = Emblem of Damascus.svg , seal_type = Seal , map_caption = , ...
had six hospitals by the 15th century, and Córdoba alone had 50 major hospitals , many exclusively for the military. The Islamic ''
bimaristan A bimaristan (; ), also known as ''dar al-shifa'' (also ''darüşşifa'' in Turkish) or simply maristan, is a hospital in the historic Islamic world. Etymology ''Bimaristan'' is a Persian word ( ''bīmārestān'') meaning "hospital", with '' ...
'' served as a center of medical treatment, as well
nursing home A nursing home is a facility for the residential care of elderly or disabled people. Nursing homes may also be referred to as skilled nursing facility (SNF) or long-term care facilities. Often, these terms have slightly different meanings to in ...
and
lunatic asylum The lunatic asylum (or insane asylum) was an early precursor of the modern psychiatric hospital. The fall of the lunatic asylum and its eventual replacement by modern psychiatric hospitals explains the rise of organized, institutional psychiatry ...
. It typically treated the poor, as the rich would have been treated in their own homes.Islamic Culture and the Medical Arts: Hospitals
United States National Library of Medicine The United States National Library of Medicine (NLM), operated by the United States federal government, is the world's largest medical library. Located in Bethesda, Maryland, the NLM is an institute within the National Institutes of Health. Its ...
Hospitals in this era were the first to require medical diplomas to license doctors, and compensation for negligence could be made. Hospitals were forbidden by law to turn away patients who were unable to pay. These hospitals were financially supported by
waqf A waqf ( ar, وَقْف; ), also known as hubous () or '' mortmain'' property is an inalienable charitable endowment under Islamic law. It typically involves donating a building, plot of land or other assets for Muslim religious or charitabl ...
s, as well as state funds.


Early modern and Enlightenment Europe

In Europe the medieval concept of Christian care evolved during the sixteenth and seventeenth centuries into a secular one. In England, after the dissolution of the monasteries in 1540 by King
Henry VIII Henry VIII (28 June 149128 January 1547) was King of England from 22 April 1509 until his death in 1547. Henry is best known for his six marriages, and for his efforts to have his first marriage (to Catherine of Aragon) annulled. His disa ...
, the church abruptly ceased to be the supporter of hospitals, and only by direct petition from the citizens of
London London is the capital and largest city of England and the United Kingdom, with a population of just under 9 million. It stands on the River Thames in south-east England at the head of a estuary down to the North Sea, and has been a majo ...
, were the hospitals St Bartholomew's, St Thomas's and St Mary of Bethlehem's (Bedlam) endowed directly by the crown; this was the first instance of secular support being provided for medical institutions. The
voluntary hospital Voluntary hospitals were created from the eighteenth century in England. In America, Ireland, and Australia, voluntary hospitals were established later. They can be distinguished from municipal hospitals, which were publicly owned, and private hosp ...
movement began in the early 18th century, with hospitals being founded in London by the 1720s, including
Westminster Hospital Westminster Hospital was a hospital in London, England, founded in 1719. In 1834 a medical school attached to the hospital was formally founded. In 1939 a newly built hospital and medical school opened in Horseferry Road, Westminster. In 1994 the ...
(1719) promoted by the
private bank Private banks are banks owned by either the individual or a general Partner (business rank), partner(s) with limited partner(s). Private banks are not incorporation (business), incorporated. In any such case, creditors can look to both the "enti ...
C. Hoare & Co and
Guy's Hospital Guy's Hospital is an NHS hospital in the borough of Southwark in central London. It is part of Guy's and St Thomas' NHS Foundation Trust and one of the institutions that comprise the King's Health Partners, an academic health science centre. ...
(1724) funded from the bequest of the wealthy merchant,
Thomas Guy Thomas Guy (1644 – 27 December 1724) was a British bookseller, investor in the South Sea Company, member of Parliament, and the founder of Guy's Hospital, London. Early life Thomas Guy was born in Horselydown in Southwark, in south London, th ...
. 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, and the London Hospital, Whitechapel, opened in 1752. 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 centres of medical innovation and discovery and the principal place for the
education Education is a purposeful activity directed at achieving certain aims, such as transmitting knowledge or fostering skills and character traits. These aims may include the development of understanding, rationality, kindness, and honesty. Va ...
and training of prospective practitioners. Some of the era's greatest
surgeon In modern medicine, a surgeon is a medical professional who performs surgery. Although there are different traditions in different times and places, a modern surgeon usually is also a licensed physician or received the same medical training as ...
s and doctors worked and passed on their knowledge at the hospitals. They also changed from being mere homes of refuge to being complex institutions for the provision of medicine and care for sick. The
Charité The Charité – Universitätsmedizin Berlin (Charité – Berlin University of Medicine) is one of Europe's largest university hospitals, affiliated with Humboldt University and Free University Berlin. With numerous Collaborative Research Cen ...
was founded in Berlin in 1710 by King
Frederick I of Prussia Frederick I (german: Friedrich I.; 11 July 1657 – 25 February 1713), of the Hohenzollern dynasty, was (as Frederick III) Elector of Brandenburg (1688–1713) and Duke of Prussia in personal union ( Brandenburg-Prussia). The latter function h ...
as a response to an outbreak of plague. The concept of voluntary hospitals also spread to
Colonial America The colonial history of the United States covers the history of European colonization of North America from the early 17th century until the incorporation of the Thirteen Colonies into the United States after the Revolutionary War. In the ...
; the
Bellevue Hospital Bellevue Hospital (officially NYC Health + Hospitals/Bellevue and formerly known as Bellevue Hospital Center) is a hospital in New York City and the oldest public hospital in the United States. One of the largest hospitals in the United States b ...
opened in 1736 (as a workhouse, then later becoming a hospital); the
Pennsylvania Hospital Pennsylvania Hospital is a private, non-profit, 515-bed teaching hospital located in Center City Philadelphia and is part of the University of Pennsylvania Health System. Founded on May 11, 1751, by Benjamin Franklin and Dr. Thomas Bond, Pennsylv ...
opened in 1752,
New York Hospital Weill Cornell Medical Center (previously known as New York Hospital or Old New York Hospital or City Hospital) is a research hospital in New York City. It is part of NewYork-Presbyterian Hospital and the teaching hospital for Cornell University. ...
(now Weill Cornell Medical Center) in 1771, and
Massachusetts General Hospital Massachusetts General Hospital (Mass General or MGH) is the original and largest teaching hospital of Harvard Medical School located in the West End neighborhood of Boston, Massachusetts. It is the third oldest general hospital in the United Stat ...
in 1811. When the
Vienna General Hospital The Vienna General Hospital (german: Allgemeines Krankenhaus der Stadt Wien), usually abbreviated to AKH, is the general hospital of the city of Vienna, Austria. It is also the city's university hospital, and the site of the Medical Univer ...
opened in 1784 (instantly becoming the world's largest hospital), physicians acquired a new facility that gradually developed into one of the most important research centres. Another Enlightenment era charitable innovation was the dispensary; these would issue the poor with
medicine Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care pract ...
s free of charge. The London Dispensary opened its doors in 1696 as the first such clinic in the
British Empire The British Empire was composed of the dominions, colonies, protectorates, mandates, and other territories ruled or administered by the United Kingdom and its predecessor states. It began with the overseas possessions and trading posts esta ...
. The idea was slow to catch on until the 1770s, 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 The Finsbury Dispensary, more fully the Finsbury Dispensary for Administering Advice and Medicines to the Poor, was a charitable dispensary giving medical treatment to poor people in Finsbury, on the edge of the City of London. It was founded i ...
(1780). Dispensaries were also opened in New York 1771,
Philadelphia Philadelphia, often called Philly, is the largest city in the Commonwealth of Pennsylvania, the sixth-largest city in the U.S., the second-largest city in both the Northeast megalopolis and Mid-Atlantic regions after New York City. Sinc ...
1786, and Boston 1796. The
Royal Naval Hospital, Stonehouse The Royal Naval Hospital, Stonehouse was a medical facility for naval officers and other ranks at Stonehouse, Plymouth. History The naval hospital was built between 1758 and 1765 to a design by the little-known Alexander Rovehead. The design was ...
,
Plymouth Plymouth () is a port city and unitary authority in South West England. It is located on the south coast of Devon, approximately south-west of Exeter and south-west of London. It is bordered by Cornwall to the west and south-west. Plymouth ...
, was a pioneer of hospital design in having "pavilions" to minimize the spread of infection.
John Wesley John Wesley (; 2 March 1791) was an English people, English cleric, Christian theology, theologian, and Evangelism, evangelist who was a leader of a Christian revival, revival movement within the Church of England known as Methodism. The soci ...
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 John Winston Howard (born 26 July 1939) is an Australian former politician who served as the 25th prime minister of Australia from 1996 to 2007, holding office as leader of the Liberal Party. His eleven-year tenure as prime minister is the s ...
, the philanthropist. In 1787 the French government sent two scholar administrators,
Coulomb The coulomb (symbol: C) is the unit of electric charge in the International System of Units (SI). In the present version of the SI it is equal to the electric charge delivered by a 1 ampere constant current in 1 second and to elementary char ...
and Tenon, who had visited most of the hospitals in Europe. They were impressed and the "pavilion" design was copied in France and throughout Europe.


19th century

English physician
Thomas Percival Thomas Percival (29 September 1740 – 30 August 1804) was an English physician, health reformer, ethicist and author who wrote an early code of medical ethics. He drew up a pamphlet with the code in 1794 and wrote an expanded version in 18 ...
(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. 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 The Apothecaries Act 1815 was an Act of the Parliament of the United Kingdom (citation 55 Geo.lll, c.194) with the long title "An Act for better regulating the Practice of Apothecaries throughout England and Wales". The Act introduced compulsory ...
made it compulsory for medical students to practise for at least half a year at a hospital as part of their training.
Florence Nightingale Florence Nightingale (; 12 May 1820 – 13 August 1910) was an English Reform movement, social reformer, statistician and the founder of modern nursing. Nightingale came to prominence while serving as a manager and trainer of nurses during t ...
pioneered the modern profession of
nursing Nursing is a profession within the health care sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other health ...
during the
Crimean War The Crimean War, , was fought from October 1853 to February 1856 between Russia and an ultimately victorious alliance of the Ottoman Empire, France, the United Kingdom and Piedmont-Sardinia. Geopolitical causes of the war included the de ...
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. Nightingale was instrumental in reforming the nature of the hospital, by improving
sanitation Sanitation refers to public health conditions related to clean drinking water and treatment and disposal of human excreta and sewage. Preventing human contact with feces is part of sanitation, as is hand washing with soap. Sanitation systems ...
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 statistical measurement for determining the success rate of a given intervention and pushed for administrative reform at hospitals. 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 National Health Service (NHS) is the umbrella term for the publicly funded healthcare systems of the United Kingdom (UK). Since 1948, they have been funded out of general taxation. There are three systems which are referred to using the " ...
, 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 Baron Carl von Rokitansky (german: Carl Freiherr von Rokitansky, cs, Karel Rokytanský; 19 February 1804 – 23 July 1878) was a Bohemian physician, pathologist, humanist philosopher and liberal politician, founder of the Viennese School of Me ...
,
Josef Škoda Josef may refer to *Josef (given name) *Josef (surname) Josef is the surname of the following people: * Jens Josef (born 1967), German composer of classical music, a flutist and academic teacher * Michelle Josef (born 1954), Canadian musician and tr ...
,
Ferdinand Ritter von Hebra Ferdinand Karl Franz Schwarzmann, Ritter von Hebra (7 September 1816, in Brno, Moravia – 5 August 1880 in Vienna, Austria-Hungary) was an Austrian physician and dermatologist known as the founder of the New Vienna School of Dermatology, an ...
, and
Ignaz Philipp Semmelweis Ignaz Philipp Semmelweis (; hu, Semmelweis Ignác Fülöp ; 1 July 1818 – 13 August 1865) was a Hungarian physician and scientist, who was an early pioneer of antiseptic procedures. Described as the "saviour of mothers", he discovered that t ...
. 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 en, Viennese , iso_code = AT-9 , registration_plate = W , postal_code_type = Postal code , postal_code = , timezone = CET , utc_offset = +1 , timezone_DST ...
, being considered as the birth of specialised medicine.


20th century and beyond

By the late 19th and early 20th centuries, medical advancements such as
anesthesia Anesthesia is a state of controlled, temporary loss of sensation or awareness that is induced for medical or veterinary purposes. It may include some or all of analgesia (relief from or prevention of pain), paralysis (muscle relaxation), ...
and sterile techniques that could make surgery less risky, and the availability of more advanced diagnostic devices such as
X-rays An X-ray, or, much less commonly, X-radiation, is a penetrating form of high-energy electromagnetic radiation. Most X-rays have a wavelength ranging from 10 Picometre, picometers to 10 Nanometre, nanometers, corresponding to frequency, ...
, continued to make hospitals a more attractive option for treatment. 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 Case mix index (CMI) within health care and medicine, is a relative value assigned to a diagnosis-related group of patients in a medical care environment. The CMI value is used in determining the allocation of resources to care for and/or treat the ...
. In the United States, the number of hospitalizations continued to grow and reached its peak in 1981 with 171 admissions per 1,000 Americans and 6,933 hospitals. 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. Occupancy rates also dropped from 77% in 1980 to 60% in 2013. 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.https://www.cdc.gov/hai/pdfs/hai/infections_deaths.pdf In the US, a patient may sleep in a hospital bed, but be considered outpatient and "under observation" if not formally admitted. In the US, 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
Center for Medicare and Medicaid Services The Centers for Medicare & Medicaid Services (CMS), is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer M ...
(CMS) introduced a "two-midnight" rule for inpatient admissions, 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. Microhospitals, with bed capacities of between eight and fifty, are expanding in the United States. Similarly, freestanding
emergency rooms An emergency department (ED), also known as an accident and emergency department (A&E), emergency room (ER), emergency ward (EW) or casualty department, is a medical treatment facility specializing in emergency medicine, the acute care of pati ...
, which transfer patients that require inpatient care to hospitals, were popularised in the 1970s and have since expanded rapidly across the United States.


Funding

Modern hospitals derive funding from a variety of sources. They may be funded by private payment and
health insurance Health insurance or medical insurance (also known as medical aid in South Africa) is a type of insurance that covers the whole or a part of the risk of a person incurring medical expenses. As with other types of insurance, risk is shared among ma ...
or
public expenditure Public expenditure is spending made by the government of a country on collective needs and wants, such as pension, provisions, security, infrastructure, etc. Until the 19th century, public expenditure was limited as laissez faire philosophies be ...
,
charitable donation The practice of charity is the voluntary giving of help to those in need, as a humanitarian act, unmotivated by self-interest. There are a number of philosophies about charity, often associated with religion. Etymology The word ''charity'' ori ...
s. In the United Kingdom, the
National Health Service The National Health Service (NHS) is the umbrella term for the publicly funded healthcare systems of the United Kingdom (UK). Since 1948, they have been funded out of general taxation. There are three systems which are referred to using the " ...
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. In the United States, hospitals typically operate privately and in some cases on a for-profit basis, such as
HCA Healthcare HCA Healthcare is an American for-profit operator of health care facilities that was founded in 1968. It is based in Nashville, Tennessee, and, as of May 2020, owns and operates 186 hospitals and approximately 2,000 sites of care, including sur ...
. The list of procedures and their prices are billed with a chargemaster; however, these prices may be lower for health care obtained within healthcare networks. Legislation requires hospitals to provide care to patients in life-threatening emergency situations regardless of the patient's ability to pay. Privately funded hospitals which admit uninsured patients in emergency situations incur direct financial losses, such as in the aftermath of
Hurricane Katrina Hurricane Katrina was a destructive Category 5 Atlantic hurricane that caused over 1,800 fatalities and $125 billion in damage in late August 2005, especially in the city of New Orleans and the surrounding areas. It was at the time the cost ...
.
Hospitals in New Orleans see surge in uninsured patients but not public funds
' – ''
USA Today ''USA Today'' (stylized in all uppercase) is an American daily middle-market newspaper and news broadcasting company. Founded by Al Neuharth on September 15, 1982, the newspaper operates from Gannett's corporate headquarters in Tysons, Virgini ...
'', Wednesday 26 April 2006


Quality and safety

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 Due to the near-universal desire for safe and good quality healthcare, there is a growing interest in international healthcare accreditation. Providing healthcare, especially of an adequate standard, is a complex and challenging process. Healthcar ...
, by groups such as
Accreditation Canada Accreditation is the independent, third-party evaluation of a conformity assessment body (such as certification body, inspection body or laboratory) against recognised standards, conveying formal demonstration of its impartiality and competence to ...
from Canada, the
Joint Commission The Joint Commission is a United States-based nonprofit tax-exempt 501(c) organization that accredits more than 22,000 US health care organizations and programs. The international branch accredits medical services from around the world. A majori ...
from the US, the
Trent Accreditation Scheme The Trent Accreditation Scheme (TAS), now replaced ''de facto'' by a number of independent accreditation schemes, such as the QHA Trent Accreditation, was a British accreditation scheme formed with a mission to maintain and continually evaluate st ...
from Great Britain, and the ''
Haute Autorité de santé Haute may refer to: People * Nicholas Haute (1357 – c.1415), English knight, landowner and politician ** William Haute (MP) (1390-1462), son of Nicholas, Member of Parliament, English politician ** William Hawte Sir William Hawte (also Haute or ...
'' (HAS) from France. In England hospitals are monitored by the
Care Quality Commission The Care Quality Commission (CQC) is an executive non-departmental public body of the Department of Health and Social Care of the United Kingdom. It was established in 2009 to regulate and inspect health and social care services in England. I ...
. In 2020 they turned their attention to
hospital food Food in UK hospitals has been the subject of attention from celebrity chefs. James Martin was tasked with revamping the menu and catering facilities at Scarborough General Hospital in September 2011, for ''Operation Hospital Food'' for the BBC. ...
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." The
World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of h ...
noted in 2011 that going into hospital was far riskier than flying. Globally the chance of a patient being subject to an error was about 10% and the chance of death resulting from an error was about 1 in 300 according to
Liam Donaldson Sir Liam Joseph Donaldson (born 3 May 1949) is a British doctor. He was formerly the Chief Medical Officer for England, being the 15th occupant of the post since it was established in 1855. As such, he was principal advisor to the United King ...
. 7% of hospitalised patients in developed countries, and 10% in developing countries, acquire at least one
health care-associated infection A hospital-acquired infection, also known as a nosocomial infection (from the Greek , meaning "hospital"), is an infection that is acquired in a hospital or other health care facility. To emphasize both hospital and nonhospital settings, it is so ...
. In the USA 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.


Architecture

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. 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: :''"... 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."
Healing by design
'' – ''Ode Magazine'', July/August 2006 issue. Accessed 10 February 2008.
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. The research of
British Medical Association The British Medical Association (BMA) is a registered trade union for doctors in the United Kingdom. The association does not regulate or certify doctors, a responsibility which lies with the General Medical Council. The association's headquar ...
is showing that good hospital design can reduce patient's recovery time. Exposure to daylight is effective in reducing depression. 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. Eliminating long corridors can reduce nurses' fatigue and stress. 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.
Health administrators go shopping for new hospital designs
'' – ''
National Review of Medicine National may refer to: Common uses * Nation or country ** Nationality – a ''national'' is a person who is subject to a nation, regardless of whether the person has full rights as a citizen Places in the United States * National, Maryland, ce ...
'', Monday 15 November 2004, Volume 1 No. 21
File:Hinduja Hospital, Mahim, Mumbai.jpg, Hinduja National Hospital, Mumbai File:Intensivstation (01) 2007-03-03.jpg, An
intensive care unit 220px, Intensive care unit An intensive care unit (ICU), also known as an intensive therapy unit or intensive treatment unit (ITU) or critical care unit (CCU), is a special department of a hospital or health care facility that provides intensiv ...
(ICU) within a hospital File:KlinikumAachen.jpg,
Uniklinikum Aachen The Uniklinikum Aachen, full German name ''Universitätsklinikum Aachen'' ("University Hospital Aachen", abbreviated ''UKA''), formerly known as ''Neues Klinikum'' ("New Clinic"), is the university hospital of the city of Aachen, Germany ...
in Germany File:TAYS,TAMPERE 1.12-09 aamulla n.klo 8 - panoramio.jpg,
Tampere University Hospital Tampere University Hospital ( fi, Tampereen yliopistollinen sairaala, TAYS, sv, Tammerfors universitetssjukhus) is a teaching hospital of Tampere University along Teiskontie at the Kauppi district in Tampere, Finland. It serves as one of the mai ...
in
Tampere Tampere ( , , ; sv, Tammerfors, ) is a city in the Pirkanmaa region, located in the western part of Finland. Tampere is the most populous inland city in the Nordic countries. It has a population of 244,029; the urban area has a population o ...
, Finland File:AIIMS central lawn.jpg,
All India Institute of Medical Sciences The All India Institutes of Medical Sciences (AIIMS) is a group of autonomous government public medical universities of higher education under the jurisdiction of Ministry of Health and Family Welfare , Government of India. These institutes ha ...
in
Delhi Delhi, officially the National Capital Territory (NCT) of Delhi, is a city and a union territory of India containing New Delhi, the capital of India. Straddling the Yamuna river, primarily its western or right bank, Delhi shares borders w ...
, India File:Lehigh-Valley-Hospital.x.jpg,
Lehigh Valley Hospital–Cedar Crest Lehigh Valley Hospital, also known as Lehigh Valley Hospital-Cedar Crest, is a hospital in Allentown, Pennsylvania. Lehigh Valley Hospital is the largest hospital in the Lehigh Valley metropolitan region and the third largest hospital in Pennsyl ...
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Allentown, Pennsylvania Allentown (Pennsylvania Dutch language, Pennsylvania Dutch: ''Allenschteddel'', ''Allenschtadt'', or ''Ellsdaun'') is a city in Lehigh County, Pennsylvania, Lehigh County, Pennsylvania. The city has a population of 125,845 as of the 2020 United ...


See also

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Burn center A burn center, burn unit, or burns unit is a hospital specializing in the treatment of burns. Burn centers are often used for the treatment and recovery of patients with more severe burns. Overview The severity of a burn, and therefore whether ...
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History of hospitals The history of hospitals began in antiquity with hospitals in Greece, the Roman Empire and on the Indian subcontinent as well, starting with precursors in the Asclepeion, Asclepian temples in ancient Greece and then the Medicine in ancient Rome#Hos ...
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History of medicine The history of medicine is both a study of medicine throughout history as well as a multidisciplinary field of study that seeks to explore and understand medical practices, both past and present, throughout human societies. More than just histo ...
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Hospital network A hospital network is a public, non-profit or for-profit company or organization that provides two or more hospitals and other broad healthcare facilities and services. A hospital network may include hospitals in one or more regions within one o ...
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Lists of hospitals These are links to lists of hospitals around the world. According to Cybermetrics Lab, they completed their rankings from over 16,500 hospitals worldwide in 2015. By continent *Lists of hospitals in Africa *Lists of hospitals in Asia *Lists of h ...
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Hospital information system A hospital information system (HIS) is an element of health informatics that focuses mainly on the administrational needs of hospitals. In many implementations, a HIS is a comprehensive, integrated information system designed to manage all the asp ...
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Trauma center A trauma center (or trauma centre) is a hospital equipped and staffed to provide care for patients suffering from major trauma, major traumatic injuries such as Falling (accident), falls, motor vehicle collisions, or gunshot wounds. A trauma cent ...
* The Waiting Room *
Hospice Hospice care is a type of health care that focuses on the palliation of a terminally ill patient's pain and symptoms and attending to their emotional and spiritual needs at the end of life. Hospice care prioritizes comfort and quality of life by ...
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Walk-in clinic A walk-in clinic (also known as a walk-in centre) is a medical facility that accepts patients on a walk-in basis and with no appointment required. A number of healthcare service providers fall under the walk-in clinic umbrella including urgent ...


Notes


References

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Bibliography


History of hospitals

* 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 * Chaney, Edward (2000),"'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. https://books.google.com/books/about/The_evolution_of_the_grand_tour.html?id=rYB_HYPsa8gC * 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 * Crawford, D.S
Bibliography of Histories of Canadian hospitals and schools of nursing
* 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 * Harrison, Mar, et al. eds. ''From Western Medicine to Global Medicine: The Hospital Beyond the West'' (2008) * Horden, Peregrine. ''Hospitals and Healing From Antiquity to the Later Middle Ages'' (2008) * McGrew, Roderick E. ''Encyclopedia of Medical History'' (1985) * * Porter, Roy. ''The Hospital in History'', with Lindsay Patricia Granshaw (1989) * Risse, Guenter B. ''Mending Bodies, Saving Souls: A History of Hospitals'' (1999); world coverage * Rosenberg, Charles E. ''The Care of Strangers: The Rise of America's Hospital System'' (1995); history to 1920 * Scheutz, Martin et al. eds. ''Hospitals and Institutional Care in Medieval and Early Modern Europe'' (2009) * Wall, Barbra Mann. ''American Catholic Hospitals: A Century of Changing Markets and Missions'' (Rutgers University Press, 2011).


External links

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WHO Who or WHO may refer to: * Who (pronoun), an interrogative or relative pronoun * Who?, one of the Five Ws in journalism * World Health Organization Arts and entertainment Fictional characters * Who, a creature in the Dr. Seuss book '' Horton He ...
Hospitals https://www.who.int/hospitals/en/ * * * {{cite web, url= https://ayurvedakidneydoctor.wordpress.com/2022/11/01/karma-ayurveda-kidney-specialist-negetive-reviews-dr-puneet-dhawan-patient-bunty-rana-review, title= karma ayurveda hospital, website= ayurvedakidneydoctor.wordpress
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