Hospital

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Image:Physician in hospital sickroom printed 1682.jpg A hospital today is an institution for professional health care provided by physicians, nurses and other professionals.

1 Terminology
2 Types
3 History
4 See also
5 External links

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Terminology

During the Middle Ages the hospital could serve other functions, such as almshouse for the poor, or hostel for pilgrims. The name comes from Latin hospes (host), which is also the root for the words hotel and hospitality. The modern word "hotel" derives from the French word "hostel" which featured a silent s that was eventually removed from the word.

Some patients just come 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.

Grammar of the word differs slightly, with American English preferring that someone is "in or at the hospital", while Commonwealth English (including some Canadian English) prefers that someone is "in hospital". Commonwealth English also maintains that "an hospital" is the correct usage in situations where the noun in question must be prefixed with an article, (though in practice, it would be highly unusual to hear any speaker of British English say "an hospital" rather than "a hospital" unless his dialect drops initial h), while in American English, "a hospital" is preferred, as the actual pronunciation of the phrase is easier due to the aspirated 'h' with which the word starts.

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Types

Image:NHS NNUH entrance.jpg Image:Paloaltoveteransaffairshospital.jpg 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/A&E department 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.

Very large hospitals are often called Medical Centers and usually conduct operations in virtually every field of modern medicine.

Most cities (especially in the U.S.) have laws that make hospitals have alternative backup power generators, in case of a blackout.

Types of specialized hospitals include trauma centers, children's hospitals, seniors' hospitals, and hospitals for dealing with specific medical needs such as psychiatric problems (see psychiatric hospital), pulmonary diseases, and so forth.

A hospital may be a single building or a campus. Some hospitals are affiliated with universities for medical research and the training of medical personnel. Within the United States, many hospitals are for-profit, while elsewhere in the world most are non-profit.

Many hospitals have hospital volunteer programs where people (usually students and senior citizens) can volunteer and provide various ancillary services.

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.

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History

In ancient cultures religion and medicine were linked. The earliest known institutions aiming to provide cure were Egyptian temples. Greek temples dedicated to the healer-god Asclepius might admit the sick, who would wait for guidance from the god in a dream. The Romans adopted his worship. Under his Roman name Æsculapius, he was provided with a temple (291 BC) on an island in the Tiber in Rome, where similar rites were performed.

Sinhalese (Sri Lankans)are perhaps responsible for introducing the concept of dedicated Hospitals to the world. According to the Mahavamsa, the ancient chronicle of Sinhalese royalty written in the 6th century A.C. King Pandukabhaya (4th century B.C.) had lying-in-homes and hospitals (Sivikasotthi-Sala) built in various parts of the country after having fortified his capital at Anuradhapura. This is the earliest literary evidence we have of the concept of dedicated hospitals anywhere in the world.

Prof. Arjuna Aluvihare ("Rohal Kramaya Lovata Dhayadha Kale Sri Lankikayo" Vidhusara Science Magazine, Nov. 1993) contends that there is no evidence, literary or otherwise, to show that hospitals were known elsewhere before and during the time of King Pandukabhaya. Heinz E Muller-Dietz (Historia Hospitalium 1975) describes Mihintale Hospital as being perhaps the oldest in the world.

Some institutions created specifically to care for the sick appeared in India. Brahmantic institutions were established in India, King Ashoka founded 18 such institutions c. 230 BC. The care was not full and only the rich were treated.

The first teaching hospital, however, where students were authorized to methodically practice on patients under the supervision of physicians as part of their education, was the Academy of Gundishapur in the Persian Empire. Some experts even claim that "to a very large extent, the credit for the whole hospital system must be given to Persia". (A medical history of Persia, C. Elgood, Cambridge Univ. Press, p. 173.)

The Romans created valetudinaria for the care of sick slaves, gladiators and soldiers around 100 BC. The adoption of Christianity as the state religion of the empire drove an expansion of the provision of care, but not just for the sick. The First Council of Nicaea in 325 A.D. urged the Church to provide for the poor, sick, widows and strangers. It ordered the construction of a hospital in every cathedral town. Among the earliest were those built by the physician Saint Sampson in Constantinople and by Basil, bishop of Caesarea. The latter was attached to a monastery and provided lodgings for poor and travelers, as well as treating the sick and infirm. There was a separate section for lepers.

Medieval hospitals in Europe followed a similar pattern. They were religious communities, with care provided by monks and nuns. (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 were multi-function. Others were founded specifically as leper hospitals, or as refuges for the poor or for pilgrims. Not all cared for the sick.

Meanwhile Muslim hospitals developed a high standard of care between the eighth and twelfth centuries A.D. Hospitals built in Baghdad in the ninth and tenth centuries employed up to twenty-five staff physicians and had separate wards for different conditions and lead to the modern hospital. State-supported hospitals also appeared in China later during the first millennium A.D.

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.

Britain led the field. Guy's Hospital was founded in London in 1724 from a bequest by wealthy merchant Thomas Guy. 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 was chartered in Philadelphia in 1751, after £2,000 from private subscription was matched by funds from the Assembly. In Continental Europe the new hospitals were generally built and run from public funds. The Charité was founded in 1710. Whatever the financing, by the mid-nineteenth century most of Europe and the United States had established a variety of public and private hospital systems.

In the United States the traditional hospital is a non-profit hospital, 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 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 hospitals in major cities and research hospitals often affiliated with a medical school. In the late twentieth century chains of for-profit hospitals have arisen.

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