| A hospital today is an institution for professional health care provided by
physicians and nurses.
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.
Some patients just 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.
Grammar of the word differs slightly, with American English preferring that someone is "in the hospital", while Commonwealth English (including some Canadian English) prefers that someone is "in hospital".
Types
The best-known 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.
Very large hospitals are often called Medical Centers and usually conduct operations in virtually every field of modern
medicine.
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.
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 proved with a temple (291 B.C.) on a island
in the Tiber in Rome, where similar rites were
performed.
The first institutions created specifically to care for the sick appeared in India.
Brahmantic hospitals were established in Sri Lanka by 431 B.C., and King Ashoka founded 18 hospitals in Hindustan c.230
B.C. The latter were provided with physicians and nurses, and supported from royal funds.
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.
The Romans created valetudinaria for the care of sick slaves, gladiators and
soldiers around 100 B.C. 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 25 staff physicians and had separate wards for different conditions. State-supported hospitals also appeared in
China 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 founded 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. 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.
Hospitals in the United States
In the United States the traditional hospital is a non-profit
hospital, usually sponsored by a religious denomination. 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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