HOSPITAL

DEFENITION OF A HOSPITAL

•A modern hospital is an institution, which possesses adequate accommodation and well qualified and experienced personnel to provide services of curative,restorative,preventive and promotive character of the highest quality possible to all people regardless of race,colour,creed or economic status. It conducts educational and training programmes for the health personnel, particularly required for patient care and hospital services. It also conducts research assisting the advancement of medical services, hospital services and programmes of health education.

THE CHANGING ROLE OF HOSPITAL

The role of hospitals has changed, with emphasis shifting from:

• Curative to preventive.• In-patient care to out-patient and home care.• Acute to chronic illness.• Tertiary and secondary to primary health care.

The important factors that have led to the changing role and functions of the hospital are:

• Expansion of clientele from dying and destitute to all classes of people.

• Improved socio-economic status.

• Increased health awareness.

• Government’s duty to provide comprehensive health care.

• Improved transportation and communication services.

• Rapid advances in medical science and technology.

• Increase in population leading to increase in demand for hospital beds.

• Reorientation of health care delivery system with an emphasis on primary health care

FUNCTIONS OF A HOSPITAL

1. INTRA-MURAL FUNCTIONS

i. Therapeutic Diagnostic Curative Rehabilitative Care of emergenciesii. Preventive Antenatal and postnatal services.Well baby clinics and immunisation schedule.Family welfare services.Control of communicable diseases.Health education

.iii. EducationMedical : Undergraduate, post-graduate and post-

doctoral.Nursing education :Undergraduate, post-graduate and

doctoral.SpecialityParamedicalCommunity healthiv. ResearchClinical medicineHospital administration

2. EXTRA-MURAL FUNCTIONS• Outpatient services• Home care/outreach/domiciliary services

CLASSIFICATION OF HOSPITALS

Hospitals can be classified in many ways.1. According to OWNERSHIP / CONTROL•Public hospitals•Voluntary (Charitable) hospitals•Private hospitals•Corporate hospitals2. According to CLINICAL SPECIALITIES3. According to LENGTH OF STAY4. According to TEACHING or NON-TEACHING

ESSENTIAL COMPONENTS OF A HOSPITAL

•Trained and competent professionals in adequate numbers

•The entire necessary infrastructure to facilitate smooth functioning of the hospital.

•An efficient organisation so that each member of the hospital is able to extend the best services to the client

•A holistic approach•An atmosphere conducive to staff, self and

professional growth by arranging regular in-service education programmes.

PLANNING OF THE HOSPITAL

1. Planning of the hospital should include :• A survey for needs of the hospital in an area and

availability of land and basic amenities like land,water,electricity etc.• Availability of adequate funds for construction,

operation and maintenance .• Scope for expansion to keep pace with changing

medical and social patterns.• Appropriate distribution of beds,e.g. medical, surgical

and paediatric as per sex ratio-male:female2. Regional Planning

HOSPITAL UTILISATION

•Factors influencing Hospital UtilisationEXTRA-MURAL FACTORS Availability of hospital beds Service coverage and bed distribution Age of the population Means of communication Morbidity and mortality rate Availability of extra-mural medical services Housing Supply of Physicians Existence of proprietary hospitals

INTRA-MURAL FACTORS Hospital’s physical layout and internal organisation Methods of payment for hospital services Hospital bottlenecks Medical customs and social patterns Research and Training