History and funding of hospitals?
Hospitals
A hospital is an institution for health care, often but not always providing care for inpatients and outpatients. Today, hospitals are usually funded by the state, health organizations (for profit or non-profit), health insurances or charities, including direct charitable donations. In history, however, they were often founded and funded by religious orders or charitable individuals and leaders. Hospitals are nowadays staffed by professional physicians, surgeons and nurses, whereas in history, this work was usually done by the founding religious orders or by volunteers.
During the Middle Ages the hospital could serve other functions, such as almshouse for the poor, hostel for pilgrims, or hospital school. The name comes from Latin hospes (host), which is also the root for the English words hotel, hostel, and hospitality. The modern word hotel derives from the French word hostel, which featured a silent s, which was eventually removed from the word. (The circumflex on modern French hôtel hints at the vanished s.)
Types
Some patients in a hospital come just for diagnosis and/or therapy and then leave (‘outpatients’); while others are ‘admitted’ and stay overnight or for several weeks or months (‘inpatients’). Hospitals are usually distinguished from other types of medical facilities by their ability to admit and care for inpatients.
General hospitals
The best-known type of hospital is the general hospital, which is set up to deal with many kinds of disease and injury, and typically has an emergency ward to deal with immediate threats to health and the capacity to dispatch emergency medical services. A general hospital is typically 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, plastic surgery, childbirth, bioassay laboratories, and so forth. Larger cities may have many different hospitals of varying sizes and facilities.Specialized hospitals
Types of specialized hospitals include trauma centers, children’s hospitals, seniors’ (geriatric) hospitals, and hospitals for dealing with specific medical needs such as psychiatric problems (see psychiatric hospital), certain disease categories, and so forth.
Clinics
A medical facility smaller than a hospital is called a clinic, and is often run by a government agency for health services or a private partnership of physicians (in nations where private practice is allowed). Clinics generally provide only outpatient services.Teaching hospital
A teaching hospital (or university hospital) is that who combines assistance to patients with teaching to medical students. Architecture hospital may be a single building or a campus. (Many hospitals with pre-20th-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.
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[1] 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 hospital designs now try to reestablish design that takes the patient’s psychological needs into account, such as providing for more air, better views and more pleasant color schemes. These ideas harken back to the late 18th 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.Another major change which is still ongoing in many parts of the world is the change from a ward-based system (where patients are treated and accommodated in communal rooms, separated at best by movable partititions) to a room-based environment, where patients are accommodated in private 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, which causes some to charge for the privilige of private rooms.
