Hospital

Hospital

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A hospital is a health care
Health care
Health care is the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Health care is delivered by practitioners in medicine, chiropractic, dentistry, nursing, pharmacy, allied health, and other care providers...

 institution providing patient
Patient
A patient is any recipient of healthcare services. The patient is most often ill or injured and in need of treatment by a physician, advanced practice registered nurse, veterinarian, or other health care provider....

 treatment by specialized staff and equipment. Hospitals often, but not always, provide for inpatient care
Inpatient care
Inpatient care is the care of patients whose condition requires admission to a hospital. Progress in modern medicine and the advent of comprehensive out-patient clinics ensure that patients are only admitted to a hospital when they are extremely ill or are have severe physical...

 or longer-term patient stays.

Hospitals are usually funded by the public sector, by health organizations (for profit
For-profit hospital
For-profit hospitals, or alternatively investor-owned hospitals, are investor-owned chains of hospitals which have been established particularly in the United States during the late twentieth century. In contrast to the traditional and more common non-profit hospitals, they attempt to garner a...

 or nonprofit
Non-profit organization
Nonprofit organization is neither a legal nor technical definition but generally refers to an organization that uses surplus revenues to achieve its goals, rather than distributing them as profit or dividends...

), health insurance
Health insurance
Health insurance is insurance against the risk of incurring medical expenses among individuals. By estimating the overall risk of health care expenses among a targeted group, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to ensure that money is...

 companies, or charities
Charitable organization
A charitable organization is a type of non-profit organization . It differs from other types of NPOs in that it centers on philanthropic goals A charitable organization is a type of non-profit organization (NPO). It differs from other types of NPOs in that it centers on philanthropic goals A...

, including direct charitable donations. Historically, hospitals were often founded and funded by religious orders or charitable individuals and leaders. Today, hospitals are largely staffed by professional physician
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...

s, surgeon
Surgeon
In medicine, a surgeon is a specialist in surgery. Surgery is a broad category of invasive medical treatment that involves the cutting of a body, whether human or animal, for a specific reason such as the removal of diseased tissue or to repair a tear or breakage...

s, and nurses, whereas in the past, this work was usually performed by the founding religious orders or by volunteers
Volunteering
Volunteering is generally considered an altruistic activity, intended to promote good or improve human quality of life, but people also volunteer for their own skill development, to meet others, to make contacts for possible employment, to have fun, and a variety of other reasons that could be...

. However, there are various Catholic
Catholic
The word catholic comes from the Greek phrase , meaning "on the whole," "according to the whole" or "in general", and is a combination of the Greek words meaning "about" and meaning "whole"...

 religious orders, such as the Alexians
Alexians
The Alexians, Alexian Brothers or Cellites are a Catholic religious institute or congregation specifically devoted to caring for the sick which has its origin in Europe at the time of the Black Death...

 and the Bon Secours Sisters
Bon Secours Sisters
Congregation of the Sisters of Bon Secours is a Roman Catholic religious congregation for nursing , whose object is to care for patients from all socio-economic groups...

, which still focus on hospital ministry today.

There are over 17,000 hospitals in the world.

In accord with the original meaning of the word, hospitals were originally "places of hospitality", and this meaning is still preserved in the names of some institutions such as the Royal Hospital Chelsea
Royal Hospital Chelsea
The Royal Hospital Chelsea is a retirement home and nursing home for British soldiers who are unfit for further duty due to injury or old age, located in the Chelsea region of central London, now the Royal Borough of Kensington and Chelsea. It is a true hospital in the original sense of the word,...

, established in 1681 as a retirement and nursing home for veteran soldiers.

Etymology


During the Middle Ages hospitals served different functions to modern institutions, being almshouses for the poor, hostels for pilgrims
Pilgrims
Pilgrims , or Pilgrim Fathers , is a name commonly applied to early settlers of the Plymouth Colony in present-day Plymouth, Massachusetts, United States...

, or hospital schools
Hospital school
A hospital school is a school operated in a hospital, generally a children's hospital which provides instruction to all primary and secondary grade levels. These schools help children regain academic progress during periods of hospitalization or rehabilitation...

. The word hospital comes from the Latin hospes, signifying a stranger or foreigner, hence a guest. Another noun derived from this, hospitium came to signify hospitality, that is the relation between guest and shelterer, hospitality, friendliness, hospitable reception. By metonymy
Metonymy
Metonymy is a figure of speech used in rhetoric in which a thing or concept is not called by its own name, but by the name of something intimately associated with that thing or concept...

 the Latin word then came to mean a guest-chamber, guest's lodging, an inn. Hospes is thus the root for the English words host (where the p was dropped for convenience of pronunciation) hospitality
Hospitality
Hospitality is the relationship between guest and host, or the act or practice of being hospitable. Specifically, this includes the reception and entertainment of guests, visitors, or strangers, resorts, membership clubs, conventions, attractions, special events, and other services for travelers...

, hospice
Hospice
Hospice is a type of care and a philosophy of care which focuses on the palliation of a terminally ill patient's symptoms.In the United States and Canada:*Gentiva Health Services, national provider of hospice and home health services...

, hostel
Hostel
Hostels provide budget oriented, sociable accommodation where guests can rent a bed, usually a bunk bed, in a dormitory and share a bathroom, lounge and sometimes a kitchen. Rooms can be mixed or single-sex, although private rooms may also be available...

 and hotel
Hotel
A hotel is an establishment that provides paid lodging on a short-term basis. The provision of basic accommodation, in times past, consisting only of a room with a bed, a cupboard, a small table and a washstand has largely been replaced by rooms with modern facilities, including en-suite bathrooms...

. The latter modern word derives from Latin via the ancient French romance word hostel, which developed a silent s, which letter was eventually removed from the word, the loss of which is signified by a circumflex
Circumflex
The circumflex is a diacritic used in the written forms of many languages, and is also commonly used in various romanization and transcription schemes. It received its English name from Latin circumflexus —a translation of the Greek περισπωμένη...

 in the modern French word hôtel. The German word 'Spital' shares similar roots.

Grammar
Grammar
In linguistics, grammar is the set of structural rules that govern the composition of clauses, phrases, and words in any given natural language. The term refers also to the study of such rules, and this field includes morphology, syntax, and phonology, often complemented by phonetics, semantics,...

 of the word differs
American and British English differences
This is one of a series of articles about the differences between British English and American English, which, for the purposes of these articles, are defined as follows:...

 slightly depending on the dialect. In the U.S., hospital usually requires an article; in Britain
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...

 and elsewhere, the word normally is used without an article when it is the object of a preposition and when referring to a patient ("in/to the hospital" vs. "in/to hospital"); in Canada
Canada
Canada is a North American country consisting of ten provinces and three territories. Located in the northern part of the continent, it extends from the Atlantic Ocean in the east to the Pacific Ocean in the west, and northward into the Arctic Ocean...

, both uses are found.

Types



Some patient
Patient
A patient is any recipient of healthcare services. The patient is most often ill or injured and in need of treatment by a physician, advanced practice registered nurse, veterinarian, or other health care provider....

s go to a hospital just for diagnosis
Diagnosis
Diagnosis is the identification of the nature and cause of anything. Diagnosis is used in many different disciplines with variations in the use of logics, analytics, and experience to determine the cause and effect relationships...

, 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 usually are distinguished from other types of medical facilities by their ability to admit and care for inpatients whilst the others often are described as clinics.

General


The best-known type of hospital is the general hospital, which is set up to deal with many kinds of disease
Disease
A disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs. It may be caused by external factors, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune...

 and injury
Injury
-By cause:*Traumatic injury, a body wound or shock produced by sudden physical injury, as from violence or accident*Other injuries from external physical causes, such as radiation injury, burn injury or frostbite*Injury from infection...

, and normally has an emergency department
Emergency department
An emergency department , also known as accident & emergency , emergency room , emergency ward , or casualty department is a medical treatment facility specialising in acute care of patients who present without prior appointment, either by their own means or by ambulance...

 to deal with immediate and urgent threats to health
Health
Health is the level of functional or metabolic efficiency of a living being. In humans, it is the general condition of a person's mind, body and spirit, usually meaning to be free from illness, injury or pain...

. Larger cities may have several hospitals of varying sizes and facilities. Some hospitals, especially in the United States, have their own ambulance
Ambulance
An ambulance is a vehicle for transportation of sick or injured people to, from or between places of treatment for an illness or injury, and in some instances will also provide out of hospital medical care to the patient...

 service.

District


A district hospital typically is the major health care facility in its region, with large numbers of beds for intensive care and long-term care; and specialized facilities for surgery
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...

, plastic surgery
Plastic surgery
Plastic surgery is a medical specialty concerned with the correction or restoration of form and function. Though cosmetic or aesthetic surgery is the best-known kind of plastic surgery, most plastic surgery is not cosmetic: plastic surgery includes many types of reconstructive surgery, hand...

, childbirth
Childbirth
Childbirth is the culmination of a human pregnancy or gestation period with the birth of one or more newborn infants from a woman's uterus...

, bioassay laboratories, and so forth.

Specialized



Types of specialized hospitals include trauma center
Trauma center
A trauma center is a hospital equipped to provide comprehensive emergency medical services to patients suffering traumatic injuries. Trauma centers grew into existence out of the realization that traumatic injury is a disease process unto itself requiring specialized and experienced...

s, rehabilitation hospitals, children's hospital
Children's hospital
A children's hospital is a hospital which offers its services exclusively to children . The number of children's hospitals proliferated in the 20th century, as pediatric medical and surgical specialties separated from internal medicine and adult surgical specialties...

s, seniors' (geriatric) hospitals, and hospitals for dealing with specific medical needs such as psychiatric
Psychiatry
Psychiatry is the medical specialty devoted to the study and treatment of mental disorders. These mental disorders include various affective, behavioural, cognitive and perceptual abnormalities...

 problems (see psychiatric hospital
Psychiatric hospital
Psychiatric hospitals, also known as mental hospitals, are hospitals specializing in the treatment of serious mental disorders. Psychiatric hospitals vary widely in their size and grading. Some hospitals may specialise only in short-term or outpatient therapy for low-risk patients...

), certain disease categories such as cardiac, oncology, or orthopedic problems, and so forth.

A hospital may be a single building or a number of buildings on a campus
Campus
A campus is traditionally the land on which a college or university and related institutional buildings are situated. Usually a campus includes libraries, lecture halls, residence halls and park-like settings...

. Many hospitals with pre-twentieth-century origins began as one building and evolved into campuses. Some hospitals are affiliated with universities for medical research and the training of medical personnel such as physicians and nurses, often called teaching hospitals. Worldwide, most hospitals are run on a nonprofit basis by governments or charities. Within the United States, most hospitals are nonprofit.

Teaching


A teaching hospital
Teaching hospital
A teaching hospital is a hospital that provides clinical education and training to future and current doctors, nurses, and other health professionals, in addition to delivering medical care to patients...

 combines assistance to patients with teaching to medical students and nurses and often is linked to a medical school, nursing school or university.

Clinics



A medical facility smaller than a hospital is generally called a clinic
Clinic
A clinic is a health care facility that is primarily devoted to the care of outpatients...

, and often is run by a government agency
Government agency
A government or state agency is a permanent or semi-permanent organization in the machinery of government that is responsible for the oversight and administration of specific functions, such as an intelligence agency. There is a notable variety of agency types...

 for health services or a private partnership
Partnership
A partnership is an arrangement where parties agree to cooperate to advance their mutual interests.Since humans are social beings, partnerships between individuals, businesses, interest-based organizations, schools, governments, and varied combinations thereof, have always been and remain commonplace...

 of physicians (in nations where private practice is allowed). Clinics generally provide only outpatient services.

Departments




Hospitals vary widely in the services they offer and therefore, in the departments they have. They may have acute services such as an emergency department
Emergency department
An emergency department , also known as accident & emergency , emergency room , emergency ward , or casualty department is a medical treatment facility specialising in acute care of patients who present without prior appointment, either by their own means or by ambulance...

 or specialist trauma centre, burn unit
Burn (injury)
A burn is a type of injury to flesh caused by heat, electricity, chemicals, light, radiation or friction. Most burns affect only the skin . Rarely, deeper tissues, such as muscle, bone, and blood vessels can also be injured...

, surgery
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...

, or urgent care
Urgent care
Urgent care is the delivery of ambulatory care in a facility dedicated to the delivery of medical care outside of a hospital emergency department, usually on an unscheduled, walk-in basis. Urgent care centers are primarily used to treat patients who have an injury or illness that requires immediate...

. These may then be backed up by more specialist units such as cardiology
Cardiology
Cardiology is a medical specialty dealing with disorders of the heart . The field includes diagnosis and treatment of congenital heart defects, coronary artery disease, heart failure, valvular heart disease and electrophysiology...

 or coronary care unit
Coronary care unit
A coronary care unit is a hospital ward specialized in the care of patients with heart attacks, unstable angina, Cardiac dysrhythmia and various other cardiac conditions that require continuous monitoring and treatment.-Characteristics:...

, intensive care unit
Intensive Care Unit
thumb|220px|ICU roomAn intensive-care unit , critical-care unit , intensive-therapy unit/intensive-treatment unit is a specialized department in a hospital that provides intensive-care medicine...

, neurology
Neurology
Neurology is a medical specialty dealing with disorders of the nervous system. Specifically, it deals with the diagnosis and treatment of all categories of disease involving the central, peripheral, and autonomic nervous systems, including their coverings, blood vessels, and all effector tissue,...

, cancer center
Cancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...

, and obstetrics and gynecology.

Some hospitals will have outpatient departments and some will have chronic treatment units such as behavioral health
Behavioral health
In psychology behavioral health, as a general concept, refers to the reciprocal relationship between human behavior, individually or socially, and the well-being of the body, mind, and spirit, whether the latter are considered individually or as an integrated whole...

 services, dentistry
Dentistry
Dentistry is the branch of medicine that is involved in the study, diagnosis, prevention, and treatment of diseases, disorders and conditions of the oral cavity, maxillofacial area and the adjacent and associated structures and their impact on the human body. Dentistry is widely considered...

, dermatology
Dermatology
Dermatology is the branch of medicine dealing with the skin and its diseases, a unique specialty with both medical and surgical aspects. A dermatologist takes care of diseases, in the widest sense, and some cosmetic problems of the skin, scalp, hair, and nails....

, psychiatric ward, rehabilitation services
Physical medicine and rehabilitation
Physical medicine and rehabilitation , physiatry or rehabilitation medicine, is a branch of medicine that aims to enhance and restore functional ability and quality of life to those with physical impairments or disabilities. A physician having completed training in this field is referred to as a...

, and physical therapy
Physical therapy
Physical therapy , often abbreviated PT, is a health care profession. Physical therapy is concerned with identifying and maximizing quality of life and movement potential within the spheres of promotion, prevention, diagnosis, treatment/intervention,and rehabilitation...

.

Common support units include a dispensary
Dispensary
A dispensary is an office in a school, hospital or other organization that dispenses medications and medical supplies. In a traditional dispensary set-up a pharmacist dispenses medication as per prescription or order form....

 or pharmacy
Pharmacy
Pharmacy is the health profession that links the health sciences with the chemical sciences and it is charged with ensuring the safe and effective use of pharmaceutical drugs...

, pathology
Pathology
Pathology is the precise study and diagnosis of disease. The word pathology is from Ancient Greek , pathos, "feeling, suffering"; and , -logia, "the study of". Pathologization, to pathologize, refers to the process of defining a condition or behavior as pathological, e.g. pathological gambling....

, and radiology
Radiology
Radiology is a medical specialty that employs the use of imaging to both diagnose and treat disease visualized within the human body. Radiologists use an array of imaging technologies to diagnose or treat diseases...

, and on the non-medical side, there often are medical records departments, release of information department
Release of Information department
A release of information department or division is found in virtually every hospital. In the United States, HIPAA and State guidelines strongly direct the rules and regulations of patient information...

s, Information Management (IM)(aka IT or IS), Clinical Engineering
Clinical engineering
Clinical engineering is a specialty within Biomedical engineering responsible primarily for applying and implementing medical technology to optimize healthcare delivery...

 (aka Biomed), Facilities Management, Plant Ops (aka Maintenance), Dining Services, and Security departments.

Early examples



In ancient cultures, religion and medicine were linked. The earliest documented institutions aiming to provide cures were ancient Egypt
Ancient Egypt
Ancient Egypt was an ancient civilization of Northeastern Africa, concentrated along the lower reaches of the Nile River in what is now the modern country of Egypt. Egyptian civilization coalesced around 3150 BC with the political unification of Upper and Lower Egypt under the first pharaoh...

ian temples
Egyptian temple
Egyptian temples were built for the official worship of the gods and commemoration of pharaohs in Ancient Egypt and in regions under Egyptian control. These temples were seen as houses for the gods or kings to whom they were dedicated...

. In ancient Greece
Ancient Greece
Ancient Greece is a civilization belonging to a period of Greek history that lasted from the Archaic period of the 8th to 6th centuries BC to the end of antiquity. Immediately following this period was the beginning of the Early Middle Ages and the Byzantine era. Included in Ancient Greece is the...

, temples dedicated to the healer-god Asclepius
Asclepius
Asclepius is the God of Medicine and Healing in ancient Greek religion. Asclepius represents the healing aspect of the medical arts; his daughters are Hygieia , Iaso , Aceso , Aglæa/Ægle , and Panacea...

, known as Asclepieia , functioned as centers of medical advice, prognosis, and healing. At these shrines, patients would enter a dream-like state of induced sleep known as "enkoimesis" not unlike anesthesia, in which they either received guidance from the deity in a dream or were cured by surgery. Asclepeia provided carefully controlled spaces conducive to healing and fulfilled several of the requirements of institutions created for healing. In the Asclepieion of Epidaurus
Epidaurus
Epidaurus was a small city in ancient Greece, at the Saronic Gulf. Two modern towns bear the name Epidavros : Palaia Epidavros and Nea Epidavros. Since 2010 they belong to the new municipality of Epidavros, part of the peripheral unit of Argolis...

, three large marble boards dated to 350 BC preserve the names, case histories, complaints, and cures of about 70 patients who came to the temple with a problem and shed it there. Some of the surgical cures listed, such as the opening of an abdominal abscess or the removal of traumatic foreign material, are realistic enough to have taken place, but with the patient in a state of enkoimesis induced with the help of soporific substances such as opium. The worship of Asclepius was adopted by the Romans
Ancient Rome
Ancient Rome was a thriving civilization that grew on the Italian Peninsula as early as the 8th century BC. Located along the Mediterranean Sea and centered on the city of Rome, it expanded to one of the largest empires in the ancient world....

. Under his Roman name Æsculapius, he was provided with a temple (291 BC) on an island in the Tiber
Tiber
The Tiber is the third-longest river in Italy, rising in the Apennine Mountains in Emilia-Romagna and flowing through Umbria and Lazio to the Tyrrhenian Sea. It drains a basin estimated at...

 in Rome, where similar rites were performed.

Institutions created specifically to care for the ill also appeared early in India
India
India , officially the Republic of India , is a country in South Asia. It is the seventh-largest country by geographical area, the second-most populous country with over 1.2 billion people, and the most populous democracy in the world...

. Fa Xian, a Chinese Buddhist monk who travelled across India ca. 400 CE, recorded in his travelogue that

The earliest surviving encyclopedia of medicine in Sanskrit is the Carakasamhita (Compendium of Caraka). This text, which describes the building of a hospital is dated by Dominik Wujastyk of the University College London
University College London
University College London is a public research university located in London, United Kingdom and the oldest and largest constituent college of the federal University of London...

 from the period between 100 BCE and CE150. According to Dr.Wujastyk, the description by Fa Xian is one of the earliest accounts of a civic hospital system anywhere in the world and, coupled with Caraka’s description of how a clinic should be equipped, suggests that India may have been the first part of the world to have evolved an organized cosmopolitan system of institutionally-based medical provision.

King Ashoka is said to have founded at least eighteen hospitals ca. 230 B.C., with physicians and nursing staff, the expense being borne by the royal treasury. Stanley Finger (2001) in his book, Origins of Neuroscience: A History of Explorations Into Brain Function, cites an Ashokan edict
Edicts of Ashoka
The Edicts of Ashoka are a collection of 33 inscriptions on the Pillars of Ashoka, as well as boulders and cave walls, made by the Emperor Ashoka of the Mauryan dynasty during his reign from 269 BCE to 231 BCE. These inscriptions are dispersed throughout the areas of modern-day Bangladesh, India,...

 translated as: "Everywhere King Piyadasi (Asoka) erected two kinds of hospitals, hospitals for people and hospitals for animals. Where there were no healing herbs for people and animals, he ordered that they be bought and planted." However Dominik Wujastyk disputes this, arguing that the edict indicates that Ashoka built rest houses (for travellers) instead of hospitals, and that this was misinterpreted due to the reference to medical herbs.

According to the Mahavamsa
Mahavamsa
The Mahavamsa is a historical poem written in the Pali language, of the kings of Sri Lanka...

, the ancient chronicle of Sinhalese royalty, written in the sixth century A.D., King Pandukabhaya of Sri Lanka
Pandukabhaya of Sri Lanka
Pandukabhaya is, according to the Mahavansa, the 6th king of Sri Lanka since the arrival of the Prince Vijaya, he reigned from 437 BC to 367 BC. According to many historians and philosophers, he is the first truly Sri Lankan king since the Vijayan invasion, and also the king who ended the conflict...

 (reigned 437 BC to 367 BC) had lying-in-homes and hospitals (Sivikasotthi-Sala) built in various parts of the country. This is the earliest documentary evidence we have of institutions specifically dedicated to the care of the sick anywhere in the world. Mihintale
Mihintale
Mihintale is a mountain peak near Anuradhapura in Sri Lanka. It is believed by Sri Lankans to be the site of a meeting between the Buddhist monk Mahinda and King Devanampiyatissa which inaugurated the presence of Buddhism in Sri Lanka...

 Hospital is the oldest in the world. Ruins of ancient hospitals in Sri Lanka
Sri Lanka
Sri Lanka, officially the Democratic Socialist Republic of Sri Lanka is a country off the southern coast of the Indian subcontinent. Known until 1972 as Ceylon , Sri Lanka is an island surrounded by the Indian Ocean, the Gulf of Mannar and the Palk Strait, and lies in the vicinity of India and the...

 are still in existence in Mihintale
Mihintale
Mihintale is a mountain peak near Anuradhapura in Sri Lanka. It is believed by Sri Lankans to be the site of a meeting between the Buddhist monk Mahinda and King Devanampiyatissa which inaugurated the presence of Buddhism in Sri Lanka...

, Anuradhapura
Anuradhapura
Anuradhapura, , is one of the ancient capitals of Sri Lanka, famous for its well-preserved ruins of ancient Lankan civilization.The city, now a UNESCO World Heritage Site, lies 205 km north of the current capital Colombo in Sri Lanka's North Central Province, on the banks of the historic...

, and Medirigiriya.

The first teaching hospital
Teaching hospital
A teaching hospital is a hospital that provides clinical education and training to future and current doctors, nurses, and other health professionals, in addition to delivering medical care to patients...

 where students were authorized to practice methodically on patients under the supervision of physicians as part of their education, was the Academy of Gundishapur
Academy of Gundishapur
The Academy of Gondishapur , also Jondishapur , was a renowned academy of learning in the city of Gundeshapur during late antiquity, the intellectual center of the Sassanid empire. It offered training in medicine, philosophy, theology and science. The faculty were versed in the Zoroastrian and...

 in the Persian Empire. One expert has argued that "to a very large extent, the credit for the whole hospital system must be given to Persia".

Roman Empire


The Romans
Roman Empire
The Roman Empire was the post-Republican period of the ancient Roman civilization, characterised by an autocratic form of government and large territorial holdings in Europe and around the Mediterranean....

 constructed buildings called valetudinaria for the care of sick slaves, gladiators, and soldiers around 100 B.C., and many were identified by later archeology. While their existence is considered proven, there is some doubt as to whether they were as widespread as was once thought, as many were identified only according to the layout of building remains, and not by means of surviving records or finds of medical tools.

The declaration of Christianity
Christianity
Christianity is a monotheistic religion based on the life and teachings of Jesus as presented in canonical gospels and other New Testament writings...

 as accepted religion in the Roman Empire drove an expansion of the provision of care. Following First Council of Nicaea
First Council of Nicaea
The First Council of Nicaea was a council of Christian bishops convened in Nicaea in Bithynia by the Roman Emperor Constantine I in AD 325...

 in 325 A.D. construction of a hospital in every cathedral
Cathedral
A cathedral is a Christian church that contains the seat of a bishop...

 town was begun. Among the earliest were those built by the physician Saint Sampson
Sampson the Hospitable
Sampson the Hospitable was a citizen of Constantinople who devoted his time to serving the poor of the city. He is venerated as a saint in the Eastern Churches.- Life :...

 in Constantinople
Constantinople
Constantinople was the capital of the Roman, Eastern Roman, Byzantine, Latin, and Ottoman Empires. Throughout most of the Middle Ages, Constantinople was Europe's largest and wealthiest city.-Names:...

 and by Basil, bishop of Caesarea
Basil of Caesarea
Basil of Caesarea, also called Saint Basil the Great, was the bishop of Caesarea Mazaca in Cappadocia, Asia Minor . He was an influential 4th century Christian theologian...

 in modern-day Turkey. Called the "Basilias", the latter resembled a city and included housing for doctors and nurses and separate buildings for various classes of patients. There was a separate section for lepers. Some hospitals maintained libraries and training programs, and doctors compiled their medical and pharmacological studies in manuscripts. Thus in-patient medical care in the sense of what we today consider a hospital, was an invention driven by Christian
Christian
A Christian is a person who adheres to Christianity, an Abrahamic, monotheistic religion based on the life and teachings of Jesus of Nazareth as recorded in the Canonical gospels and the letters of the New Testament...

 mercy and Byzantine
Byzantine
Byzantine usually refers to the Roman Empire during the Middle Ages.Byzantine may also refer to:* A citizen of the Byzantine Empire, or native Greek during the Middle Ages...

 innovation. Byzantine hospital staff included the Chief Physician (archiatroi), professional nurses (hypourgoi) and the orderlies (hyperetai). By the twelfth century, Constantinople had two well-organized hospitals, staffed by doctors who were both male and female. Facilities included systematic treatment procedures and specialized wards for various diseases.

A hospital and medical training center also existed at Jundishapur. The city of Jundishapur was founded in 271 CE by the Sassanid king Shapur I
Shapur I
Shapur I or also known as Shapur I the Great was the second Sassanid King of the Second Persian Empire. The dates of his reign are commonly given as 240/42 - 270/72, but it is likely that he also reigned as co-regent prior to his father's death in 242 .-Early years:Shapur was the son of Ardashir I...

. It was one of the major cities in Khuzestan province of the Persian empire in what is today Iran
Iran
Iran , officially the Islamic Republic of Iran , is a country in Southern and Western Asia. The name "Iran" has been in use natively since the Sassanian era and came into use internationally in 1935, before which the country was known to the Western world as Persia...

. A large percentage of the population were Syriacs, most of whom were Christians. Under the rule of Khusraw I, refuge was granted to Greek
Greece
Greece , officially the Hellenic Republic , and historically Hellas or the Republic of Greece in English, is a country in southeastern Europe....

 Nestorian Christian philosophers including the scholars of the Persian School of Edessa
Edessa, Mesopotamia
Edessa is the Greek name of an Aramaic town in northern Mesopotamia, as refounded by Seleucus I Nicator. For the modern history of the city, see Şanlıurfa.-Names:...

 (Urfa)(also called the Academy of Athens
Athens
Athens , is the capital and largest city of Greece. Athens dominates the Attica region and is one of the world's oldest cities, as its recorded history spans around 3,400 years. Classical Athens was a powerful city-state...

), a Christian
Christian
A Christian is a person who adheres to Christianity, an Abrahamic, monotheistic religion based on the life and teachings of Jesus of Nazareth as recorded in the Canonical gospels and the letters of the New Testament...

 theological and medical university. These scholars made their way to Jundishapur in 529 following the closing of the academy by Emperor Justinian. They were engaged in medical sciences and initiated the first translation projects of medical texts. The arrival of these medical practitioners from Edessa marks the beginning of the hospital and medical center at Jundishapur. It included a medical school and hospital (bimaristan), a pharmacology laboratory, a translation house, a library and an observatory. Indian doctors also contributed to the school at Jundishapur, most notably the medical researcher Mankah. Later after Islamic invasion, the writings of Mankah and of the Indian doctor Sustura were translated into Arabic at Baghdad
Baghdad
Baghdad is the capital of Iraq, as well as the coterminous Baghdad Governorate. The population of Baghdad in 2011 is approximately 7,216,040...

.

Medieval Islamic world


Jundishapur surrendered to Islam in 636 AD. The first physicians under Muslim rule were Christians or Jews
Jews
The Jews , also known as the Jewish people, are a nation and ethnoreligious group originating in the Israelites or Hebrews of the Ancient Near East. The Jewish ethnicity, nationality, and religion are strongly interrelated, as Judaism is the traditional faith of the Jewish nation...

. One source indicates the first prominent Islamic hospital was founded in Damascus
Damascus
Damascus , commonly known in Syria as Al Sham , and as the City of Jasmine , is the capital and the second largest city of Syria after Aleppo, both are part of the country's 14 governorates. In addition to being one of the oldest continuously inhabited cities in the world, Damascus is a major...

, Syria
Syria
Syria , officially the Syrian Arab Republic , is a country in Western Asia, bordering Lebanon and the Mediterranean Sea to the West, Turkey to the north, Iraq to the east, Jordan to the south, and Israel to the southwest....

 in around 707 with assistance from Christians. However most agree that the establishment at Baghdad
Baghdad
Baghdad is the capital of Iraq, as well as the coterminous Baghdad Governorate. The population of Baghdad in 2011 is approximately 7,216,040...

 was the most influential. The public hospital
Public hospital
A public hospital or government hospital is a hospital which is owned by a government and receives government funding. This type of hospital provides medical care free of charge, the cost of which is covered by the funding the hospital receives....

 in Baghdad
Baghdad
Baghdad is the capital of Iraq, as well as the coterminous Baghdad Governorate. The population of Baghdad in 2011 is approximately 7,216,040...

 was opened during the Abbasid Caliphate of Harun al-Rashid
Harun al-Rashid
Hārūn al-Rashīd was the fifth Arab Abbasid Caliph in Iraq. He was born in Rey, Iran, close to modern Tehran. His birth date remains a point of discussion, though, as various sources give the dates from 763 to 766)....

 in the 8th century. The bimaristan
Bimaristan
Bimaristan is a Persian word meaning hospital, with Bimar- from Middle Persian of vīmār or vemār, meaning "sick" plus -stan as location and place suffix...

 (medical school) and bayt al-hikmah (house of wisdom
House of Wisdom
The House of Wisdom was a library and translation institute established in Abbassid-era Baghdad, Iraq. It was a key institution in the Translation Movement and considered to have been a major intellectual centre during the Islamic Golden Age...

) were established by professors and graduates from Jundishapur. It was headed by the Christian physician Jibrael ibn Bukhtishu
Jabril ibn Bukhtishu
Jabril ibn Bukhtishu, also written as Bakhtyshu, was an 8-9th century physician from the Bukhtishu family of Persian Nestorian physicians from the Academy of Gundishapur...

 from Jundishapur and later by Islamic physicians. "Bimaristan
Bimaristan
Bimaristan is a Persian word meaning hospital, with Bimar- from Middle Persian of vīmār or vemār, meaning "sick" plus -stan as location and place suffix...

" is a compound of “bimar” (sick or ill) and “stan” (place). In the medieval Islamic world
Islamic Golden Age
During the Islamic Golden Age philosophers, scientists and engineers of the Islamic world contributed enormously to technology and culture, both by preserving earlier traditions and by adding their own inventions and innovations...

, the word "bimaristan
Bimaristan
Bimaristan is a Persian word meaning hospital, with Bimar- from Middle Persian of vīmār or vemār, meaning "sick" plus -stan as location and place suffix...

" referred to a hospital establishment where the ill were welcomed, cared for and treated by qualified staff.

In the ninth and tenth centuries the hospital in Baghdad
Baghdad
Baghdad is the capital of Iraq, as well as the coterminous Baghdad Governorate. The population of Baghdad in 2011 is approximately 7,216,040...

 employed twenty-five staff physicians and had separate wards for different conditions. The Al-Qairawan hospital and mosque, in Tunisia
Tunisia
Tunisia , officially the Tunisian RepublicThe long name of Tunisia in other languages used in the country is: , is the northernmost country in Africa. It is a Maghreb country and is bordered by Algeria to the west, Libya to the southeast, and the Mediterranean Sea to the north and east. Its area...

, were built under the Aghlabid
Aghlabid
The Aghlabids were a dynasty of emirs, members of the Arab tribe of Bani Tamim, who ruled Ifriqiya, nominally on behalf of the Abbasid Caliph, for about a century, until overthrown by the new power of the Fatimid.-History:...

 rule in 830 and was simple, but adequately equipped with halls organized into waiting rooms, a mosque
Mosque
A mosque is a place of worship for followers of Islam. The word is likely to have entered the English language through French , from Portuguese , from Spanish , and from Berber , ultimately originating in — . The Arabic word masjid literally means a place of prostration...

, and a special bath. The first hospital in Egypt was opened in 872 and thereafter public hospitals sprang up all over the empire from Islamic Spain
Al-Andalus
Al-Andalus was the Arabic name given to a nation and territorial region also commonly referred to as Moorish Iberia. The name describes parts of the Iberian Peninsula and Septimania governed by Muslims , at various times in the period between 711 and 1492, although the territorial boundaries...

 and the Maghrib
Maghrib
The Maghrib prayer , prayed just after sunset, is the fourth of five formal daily prayers performed by practicing Muslims.The formal daily prayers of Islam comprise different numbers of units, called rak'at. The Maghrib prayer has three obligatory rak'at. The first two fard rak'at are prayed...

 to Persia
History of Iran
The history of Iran has been intertwined with the history of a larger historical region, comprising the area from the Danube River in the west to the Indus River and Jaxartes in the east and from the Caucasus, Caspian Sea, and Aral Sea in the north to the Persian Gulf and the Gulf of Oman and Egypt...

. The first Islamic psychiatric hospital
Psychiatric hospital
Psychiatric hospitals, also known as mental hospitals, are hospitals specializing in the treatment of serious mental disorders. Psychiatric hospitals vary widely in their size and grading. Some hospitals may specialise only in short-term or outpatient therapy for low-risk patients...

 was built in Baghdad
Baghdad
Baghdad is the capital of Iraq, as well as the coterminous Baghdad Governorate. The population of Baghdad in 2011 is approximately 7,216,040...

 in 705. Many other Islamic hospitals also often had their own wards dedicated to mental health. Thus between the eighth and twelfth centuries CE Muslim hospitals developed a high standard of care.

Some suggest that physicians and surgeons were appointed who gave lectures to medical students and issued diploma
Diploma
A diploma is a certificate or deed issued by an educational institution, such as a university, that testifies that the recipient has successfully completed a particular course of study or confers an academic degree. In countries such as the United Kingdom and Australia, the word diploma refers to...

s (ijazah
Ijazah
An ijazah is a certificate used primarily by Sunni Muslims to indicate that one has been authorized by a higher authority to transmit a certain subject or text of Islamic knowledge...

) to those who were considered qualified to practice. However others assert that, in contrast to medieval Europe, medical school
Medical school
A medical school is a tertiary educational institution—or part of such an institution—that teaches medicine. Degree programs offered at medical schools often include Doctor of Osteopathic Medicine, Bachelor/Doctor of Medicine, Doctor of Philosophy, master's degree, or other post-secondary...

s under Islam did not develop a system of academic evaluation and certification.

Medieval Europe


Medieval hospitals in Europe followed a similar pattern to the Byzantine
Byzantine
Byzantine usually refers to the Roman Empire during the Middle Ages.Byzantine may also refer to:* A citizen of the Byzantine Empire, or native Greek during the Middle Ages...

. They were religious communities, with care provided by monk
Monk
A monk is a person who practices religious asceticism, living either alone or with any number of monks, while always maintaining some degree of physical separation from those not sharing the same purpose...

s and nun
Nun
A nun is a woman who has taken vows committing her to live a spiritual life. She may be an ascetic who voluntarily chooses to leave mainstream society and live her life in prayer and contemplation in a monastery or convent...

s. (An old French term for hospital is hôtel-Dieu, "hostel of God.") Some were attached to monasteries; others were independent and had their own endowments, usually of property, which provided income for their support. Some hospitals were multi-functional while others were founded for specific purposes such as leper hospitals, or as refuges for the poor, or for pilgrim
Pilgrim
A pilgrim is a traveler who is on a journey to a holy place. Typically, this is a physical journeying to some place of special significance to the adherent of a particular religious belief system...

s: not all cared for the sick. The first Spanish hospital, founded by the Catholic Visigoth
Visigoth
The Visigoths were one of two main branches of the Goths, the Ostrogoths being the other. These tribes were among the Germans who spread through the late Roman Empire during the Migration Period...

 bishop Masona
Masona
Masona or Mausona was the Bishop of Mérida and metropolitan of the province of Lusitania from about 570 until his death...

 in 580AD at Mérida
Mérida, Spain
Mérida is the capital of the autonomous community of Extremadura, western central Spain. It has a population of 57,127 . The Archaeological Ensemble of Mérida is a UNESCO World Heritage site since 1993.- Climate :...

, was a xenodochium designed as an inn for travellers (mostly pilgrims to the shrine of Eulalia of Mérida) as well as a hospital for citizens and local farmers. The hospital's endowment consisted of farms to feed its patients and guests.

The Ospedale Maggiore
Ospedale Maggiore
The Ospedale Maggiore, traditionally named Ca' Granda , is a building in the center of Milan, northern Italy, constructed to house one of the first community hospitals, the largest such undertaking of the fifteenth century...

, traditionally named Ca' Granda (i.e. Big House), in Milan
Milan
Milan is the second-largest city in Italy and the capital city of the region of Lombardy and of the province of Milan. The city proper has a population of about 1.3 million, while its urban area, roughly coinciding with its administrative province and the bordering Province of Monza and Brianza ,...

, northern Italy, was constructed to house one of the first community hospitals, the largest such undertaking of the fifteenth century. Commissioned by Francesco Sforza in 1456 and designed by Antonio Filarete it is among the first examples of Renaissance architecture in Lombardy.

Colonial America


The first hospital founded in the Americas was the Hospital San Nicolás de Bari [Calle Hostos] in Santo Domingo
Santo Domingo
Santo Domingo, known officially as Santo Domingo de Guzmán, is the capital and largest city in the Dominican Republic. Its metropolitan population was 2,084,852 in 2003, and estimated at 3,294,385 in 2010. The city is located on the Caribbean Sea, at the mouth of the Ozama River...

, Distrito Nacional
Distrito Nacional
The Distrito Nacional is a subdivision of the Dominican Republic enclosing the capital Santo Domingo. It is not within any of the provinces, but is itself counted as a province. Before October 16, 2001, the Distrito Nacional was much larger, including what is now known as Santo Domingo Province....

 Dominican Republic
Dominican Republic
The Dominican Republic is a nation on the island of La Hispaniola, part of the Greater Antilles archipelago in the Caribbean region. The western third of the island is occupied by the nation of Haiti, making Hispaniola one of two Caribbean islands that are shared by two countries...

. Fray Nicolás de Ovando
Nicolás de Ovando
Fray Nicolás de Ovando y Cáceres was a Spanish soldier from a noble family and a Knight of the Order of Alcántara. He was Governor of the Indies from 1502 until 1509...

, Spanish governor and colonial administrator from 1502–1509, authorized its construction on December 29, 1503. This hospital apparently incorporated a church. The first phase of its construction was completed in 1519, and it was rebuilt in 1552. Abandoned in the mid-eighteenth century, the hospital now lies in ruins near the Cathedral in Santo Domingo.

Conquistador
Conquistador
Conquistadors were Spanish soldiers, explorers, and adventurers who brought much of the Americas under the control of Spain in the 15th to 16th centuries, following Europe's discovery of the New World by Christopher Columbus in 1492...

 Hernán Cortés
Hernán Cortés
Hernán Cortés de Monroy y Pizarro, 1st Marquis of the Valley of Oaxaca was a Spanish Conquistador who led an expedition that caused the fall of the Aztec Empire and brought large portions of mainland Mexico under the rule of the King of Castile in the early 16th century...

 founded the two earliest hospitals in North America: the Immaculate Conception
Immaculate Conception
The Immaculate Conception of Mary is a dogma of the Roman Catholic Church, according to which the Virgin Mary was conceived without any stain of original sin. It is one of the four dogmata in Roman Catholic Mariology...

 Hospital and the Saint Lazarus Hospital. The oldest was the Immaculate Conception, now the Hospital de Jesús Nazareno
Hospital de Jesús Nazareno
The Church and Hospital of Jesús Nazareno are supposedly located at the spot where Hernán Cortés and Moctezuma II met for the first time in 1519, which was then the beginning of the causeway leading to Iztapalapa. Cortés ordered the hospital built to tend to soldiers wounded fighting with the...

 in Mexico City
Mexico City
Mexico City is the Federal District , capital of Mexico and seat of the federal powers of the Mexican Union. It is a federal entity within Mexico which is not part of any one of the 31 Mexican states but belongs to the federation as a whole...

, founded in 1524 to care for the poor.

The first hospital north of Mexico
Mexico
The United Mexican States , commonly known as Mexico , is a federal constitutional republic in North America. It is bordered on the north by the United States; on the south and west by the Pacific Ocean; on the southeast by Guatemala, Belize, and the Caribbean Sea; and on the east by the Gulf of...

 was the Hôtel-Dieu de Québec
Hôtel-Dieu de Québec
The Hotel-Dieu de Québec is a teaching hospital located in Quebec City, Quebec, Canada and affiliated with Université Laval's medical school. It is part of the Centre hospitalier universitaire de Québec , a network of three teaching hospitals and several specialized institutions. Its areas of...

. It was established in New France
New France
New France was the area colonized by France in North America during a period beginning with the exploration of the Saint Lawrence River by Jacques Cartier in 1534 and ending with the cession of New France to Spain and Great Britain in 1763...

 in 1639 by three Augustinians
Augustinians
The term Augustinians, named after Saint Augustine of Hippo , applies to two separate and unrelated types of Catholic religious orders:...

 from l'Hôtel-Dieu de Dieppe in France. The project, begun by the niece of Cardinal de Richelieu was granted a royal charter by King Louis XIII and staffed by a colonial physician, Robert Giffard de Moncel
Robert Giffard de Moncel
Robert Giffard de Moncel was a French surgeon and apothecary who became a prestigious colonist and businessman and eventually a nobleman of New France....

.

Modern era


In Europe the medieval concept of Christian care evolved during the sixteenth and seventeenth centuries into a secular one, but it was in the eighteenth century that the modern hospital began to appear, serving only medical needs and staffed with physicians and surgeons. The Charité
Charité
The Charité - Universitätsmedizin Berlin is the medical school for both the Humboldt University and the Free University of Berlin. After the merger with their fourth campus in 2003, the Charité is one of the largest university hospitals in Europe....

 (founded in Berlin in 1710) is an early example.

Guy's Hospital
Guy's Hospital
Guy's Hospital is a large NHS hospital in the borough of Southwark in south east London, England. It is administratively a part of Guy's and St Thomas' NHS Foundation Trust. It is a large teaching hospital and is home to the King's College London School of Medicine...

 was founded in London
London
London is the capital city of :England and the :United Kingdom, the largest metropolitan area in the United Kingdom, and the largest urban zone in the European Union by most measures. Located on the River Thames, London has been a major settlement for two millennia, its history going back to its...

 in 1724 from a bequest by the wealthy merchant, Thomas Guy
Thomas Guy
Thomas Guy was a British bookseller, speculator and de facto founder of Guy's Hospital, London-Early life:Thomas Guy was born a son of a lighterman, wharf owner and coal-dealer at Southwark. In 1668, after eight years as an apprentice of a bookseller, he began his own bookstore in Lombard Street...

. Other hospitals sprang up in London and other British cities over the century, many paid for by private subscriptions. In the British American colonies the Pennsylvania General Hospital
Pennsylvania Hospital
Pennsylvania Hospital is a hospital in Center City, Philadelphia, affiliated with the University of Pennsylvania Health System . Founded on May 11, 1751 by Benjamin Franklin and Thomas Bond, it was the first hospital in the United States...

 was chartered in Philadelphia in 1751, after £2,000 from private subscription was matched by funds from the Assembly.

When the Vienna General Hospital
Vienna General Hospital
The Vienna General Hospital is the University medical center of the city of Vienna, Austria. The AKH is the largest hospital of Austria and Europe, the second largest hospital in the world, and at 85-m high is one of the tallest hospital buildings in the world...

 opened in 1784 (instantly becoming the world's largest hospital), physicians acquired a new facility that gradually developed into the most important research center. During the nineteenth century, the Second Viennese Medical School emerged with the contributions of physicians such as Carl Freiherr von Rokitansky
Carl Freiherr von Rokitansky
Baron Carl von Rokitansky , was a Bohemian physician, pathologist, humanist philosopher and liberal politician.-Medical career:...

, Josef Škoda
Josef Škoda
Joseph Škoda was a Czech physician, medical professor and dermatologist. Together with Carl Freiherr von Rokitansky, he was the founder of the Modern Medical School of Vienna.-Life:...

, Ferdinand Ritter von Hebra
Ferdinand Ritter von Hebra
Ferdinand Ritter von Hebra was an Austrian physician and dermatologist,...

, and Ignaz Philipp Semmelweis. Basic medical science expanded and specialization advanced. Furthermore, the first dermatology, eye, as well as ear, nose, and throat clinics in the world were founded in Vienna
Vienna
Vienna is the capital and largest city of the Republic of Austria and one of the nine states of Austria. Vienna is Austria's primary city, with a population of about 1.723 million , and is by far the largest city in Austria, as well as its cultural, economic, and political centre...

, being considered as the birth of specialized medicine.

By the mid-nineteenth century most of Europe and the United States had established a variety of public and private hospital systems. In continental Europe the new hospitals generally were built and run from public funds. The National Health Service
National Health Service
The National Health Service is the shared name of three of the four publicly funded healthcare systems in the United Kingdom. They provide a comprehensive range of health services, the vast majority of which are free at the point of use to residents of the United Kingdom...

, the principle provider of health care in the United Kingdom, was founded in 1948.

In the United States the traditional hospital is a non-profit hospital
Non-profit hospital
A non-profit hospital, or not-for-profit hospital, is a hospital which is organized as a non-profit corporation. Based on their charitable purpose and most often affiliated with a religious denomination they are a traditional means of delivering medical care in the United States...

, usually sponsored by a religious denomination. One of the earliest of these "almshouses" in what would become the United States was started by William Penn
William Penn
William Penn was an English real estate entrepreneur, philosopher, and founder of the Province of Pennsylvania, the English North American colony and the future Commonwealth of Pennsylvania. He was an early champion of democracy and religious freedom, notable for his good relations and successful...

 in Philadelphia in 1713. These hospitals are tax-exempt due to their charitable purpose, but provide only a minimum of charitable medical care. They are supplemented by large public hospital
Public hospital
A public hospital or government hospital is a hospital which is owned by a government and receives government funding. This type of hospital provides medical care free of charge, the cost of which is covered by the funding the hospital receives....

s in major cities and research hospitals often affiliated with a medical school. The largest public hospital system in America is the New York City Health and Hospitals Corporation
New York City Health and Hospitals Corporation
The New York City Health and Hospitals Corporation operates the public hospitals and clinics in New York City. A public benefit corporation with $6.7 billion in annual revenues, HHC is the largest municipal healthcare system in the United States serving 1.3 million patients, including more than...

, which includes Bellevue Hospital, the oldest U.S. hospital, affiliated with New York University Medical School. In the late twentieth century, chains of for-profit hospital
For-profit hospital
For-profit hospitals, or alternatively investor-owned hospitals, are investor-owned chains of hospitals which have been established particularly in the United States during the late twentieth century. In contrast to the traditional and more common non-profit hospitals, they attempt to garner a...

s arose in the United States. The decline in the membership of religious orders has changed the status of Catholic hospitals.

In the 2000s, modern private hospitals began to appear in developing countries such as India.

Criticism


While hospitals, by concentrating equipment, skilled staff and other resources in one place, clearly provide important help to patients with serious or rare health problems, hospitals also are criticised for a number of faults, some of which are endemic to the system, others which develop from what some consider wrong approaches to health care.

One criticism often voiced is the 'industrialised' nature of care, with constantly shifting treatment staff, which dehumanises the patient and prevents more effective care as doctors and nurses rarely are intimately familiar with the patient. The high working pressures often put on the staff can sometimes exacerbate such rushed and impersonal treatment. The architecture and setup of modern hospitals often is voiced as a contributing factor to the feelings of faceless treatment many people complain about.

Funding


In the modern era, hospitals are, broadly, either funded by the government of the country in which they are situated, or survive financially by competing in the private sector (a number of hospitals also are still supported by the historical type of charitable or religious associations).

In the United Kingdom for example, a relatively comprehensive, "free at the point of delivery" health care system exists, funded by the state. Hospital care is thus relatively easily available to all legal residents, although free emergency care is available to anyone, regardless of nationality or status. As hospitals prioritize their limited resources, there is a tendency for 'waiting lists' for non-crucial treatment in countries with such systems, as opposed to letting higher-payers get treated first, so sometimes those who can afford it take out private health care to get treatment more quickly. On the other hand, many countries, including the USA, have in the twentieth century followed a largely private-based, for-profit
Business
A business is an organization engaged in the trade of goods, services, or both to consumers. Businesses are predominant in capitalist economies, where most of them are privately owned and administered to earn profit to increase the wealth of their owners. Businesses may also be not-for-profit...

-approach to providing hospital care, with few state-money supported 'charity' hospitals remaining today. Where for-profit hospitals in such countries admit uninsured patients in emergency situations (such as during and after Hurricane Katrina
Hurricane Katrina
Hurricane Katrina of the 2005 Atlantic hurricane season was a powerful Atlantic hurricane. It is the costliest natural disaster, as well as one of the five deadliest hurricanes, in the history of the United States. Among recorded Atlantic hurricanes, it was the sixth strongest overall...

 in the USA), they incur direct financial losses, ensuring that there is a clear disincentive to admit such patients.

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
Hospital accreditation
Hospital accreditation has been defined as “A self-assessment and external peer assessment process used by health care organizations to accurately assess their level of performance in relation to established standards and to implement ways to continuously improve”...

 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
International healthcare accreditation
Due to the near-universal desire for quality healthcare, there is a growing interest in international healthcare accreditation. Providing healthcare, especially of an adequate standard, is a complex and challenging process...

, by groups such as Accreditation Canada from Canada
Canada
Canada is a North American country consisting of ten provinces and three territories. Located in the northern part of the continent, it extends from the Atlantic Ocean in the east to the Pacific Ocean in the west, and northward into the Arctic Ocean...

, the Joint Commission from the USA, the Trent Accreditation Scheme
Trent Accreditation Scheme
The Trent Accreditation Scheme , , was a British accreditation scheme formed with a mission to maintain and continually evaluate standards of quality, especially in health care delivery, through the surveying and accreditation of health care organisations, especially...

 from Great Britain, and Haute Authorité de santé (HAS) from France.

Architecture




Modern hospital buildings are designed to minimize the effort of medical personnel and the possibility of contamination while maximizing the efficiency of the whole system. Travel time for personnel within the hospital and the transportation of patients between units is facilitated and minimized. 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, the reality is that 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."


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 hearken 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
British Medical Association
The British Medical Association is the professional association and 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 headquarters are located in BMA House,...

 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 improvies patient's mood, reduces blood pressure and stress level. 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.

See also

  • List of hospitals
  • Burn center
    Burn center
    A Burn center 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....

  • Trauma center
    Trauma center
    A trauma center is a hospital equipped to provide comprehensive emergency medical services to patients suffering traumatic injuries. Trauma centers grew into existence out of the realization that traumatic injury is a disease process unto itself requiring specialized and experienced...

  • The Waiting Room (documentary)
    The Waiting Room (documentary)
    The Waiting Room is a 2011 documentary film and social media project directed by Peter Nicks that follows the life and times of patients, doctors, and staff at Highland Hospital, a safety-net hospital in Oakland, CA....


External links