Hospital
Institution with an organized medical and nursing staff, and with permanent facilities, that provides a full range of medical services, including surgery, for people requiring treatment or observation.
History
Some authorities state that as long ago as 4000 BC temples of the ancient gods were used as houses of refuge for the sick and infirm and as training schools for doctors. The number of hospitals grew in the first centuries of the Christian era and after the rise of the monastic religious orders. Through the Renaissance, and even later, hospitals were almost entirely run by religious groups.
In the 18th century, municipal hospitals operated by the civil authorities began to appear. From the middle of the 19th century on, the number of hospitals, particularly in the United States, greatly increased, principally because of the discovery of anesthesia and aseptic surgical techniques. The modern general hospital ranges from an urban medical center with a thousand or more beds to a 10- or 20-bed hospital serving a community of a few thousand with general care.
Types of Hospital
The majority of hospitals in the United States are short-stay, nonprofit institutions operated by community or religious groups. Public general hospitals are operated by federal, state, and city governments. A growing number of the hospitals in the country are operated as profit-making institutions by individuals or corporations. A modern general hospital, even of moderate size, is a complex institution. In addition to its purely medical functions, the hospital must also provide shelter, heat, food, and other services to its patients and staff.
Hospital Administration
The typical nonprofit community hospital is run by a board of trustees with general control of the hospital finances, policy, and operations. The board appoints members of the medical staff and the chief executive officer, who supervises the hospital's operation. The medical staff is usually self-governing and is delegated by the board of trustees to supervise medical services. The chief of the medical staff has administrative responsibility for the medical staff.
Hospital Services and Rise in Costs
With the spread of hospitalization insurance in the United States, demand for hospital services has grown at an unprecedented rate. Two main factors have caused recent hospital costs to climb at more than twice the inflation rate. One is the cost of equipment and tests needed for rapidly changing treatments. The greatest expense, however, is the huge staff needed to operate a hospital, which accounts for 70 percent of the costs.
In the late 1970s and early 1980s, many U.S. municipal hospitals ran up large deficits and had to cut back services or close down. Their financial distress was due to the flight of wealthier patients to private hospitals, and to more use of emergency units by the so-called medically indigent—those people who were above the income level for Medicaid but could not afford private insurance.