UNIT - II
Definition - Types of Hospital - Role perception of Hospital - Hospital as a system.
________________________________________________________________________________
DEFINITION OF HOSPITAL
A Hospital is an integral part of a Social and Medical organisation, the function of which is to
provide for the population complete health care, both curative and preventive, and whose outpatient
services reach out to the family and its home environment; the hospital is also a centre for the
training of health workers and biosocial research.
- WHO (World Health Organisation)
TYPES / CLASSIFICATION OF HOSPITAL
They classified according to,
Length of stay of patient
Clinical basis
Ownership
Objectives
Size
Management
System of medicine
1) LENGTH OF STAY
Short term
LLLength of stay
Long term
Short term :
Patients stay for shorter duration such as 1 or 2 days upto 20 days
Long term :
Patients stay for a long term such as months or years in the hospital
2) CLINICAL BASIS
General
Clinical basis
Specialty
General Hospital:
Hospitals provide treatment for common diseases & conditions. Eg: PHC,Rural taluk hospitals
Specialized Hospital:
Hospitals such as Ortho, Oncology, ENT, Cardiology and Dermatology
3) BASED ON OWNERSHIP
Public hospitals
Ownership
Voluntary Nursing homes
Voluntary hospitals
Corporative hospitals
Voluntary Nursing Homes :
It is a residential care of senior citizens or disabled people
Voluntary Hospitals:
Hospitals operated by a voluntary body / trust / charitable society etc. Also hospitals run by
missionary bodies & cooperations. Eg: CMC Vellore
Corporative Hospitals:
Hospitals are owned by an individual owner or by private organisation
4) BASED ON OBJECTIVES
Teaching research hospitals
Objectives General hospitals
Specialized hospitals
Isolation hospitals
Teaching Research Hospitals:
Medical college hospitals ( Medical, Paramedical, Nursing Students). 500 bedded hospital.
Isolation Hospitals:
Leprosy, Tuberculosis and AIDS etc
5) BASED ON SIZE
Teaching hospitals
Size
District hospitals
Thaluk hospitals
Community Health Center (CHC)
Primary Health Center (PHC)
District Hospitals:
It has major health care facility with beds for intensive care & additional beds for patients who
need long term care. 200 beds upto 300 bedded hospital.
Thaluk Hospitals:
These provide comprehensive specialist & referral service to the community through sub-district
hospital. 50 bedded hospital.
Community Health Center (CHC) :
These are private, non- profit organization provide medical service for advanced stage medical
issues. 30 bedded hospital.
Primary Health Center (PHC) :
These offer inexpensive health care at primary stages. 6 to 10 bedded hospital
6) BASED ON MANAGEMENT
Union government hospitals
Management State government hospitals
Autonomous bodies
Voluntary agencies
Private hospitals
Union Government Hospitals :
Hospitals controlled by the government of India & run by the Railways, Military / Defense
State Government Hospitals:
Those controlled by the state or union territory
Autonomous Bodies:
Under state legislation & supported by the Central government. AIIMS (New Delhi) , PGIMER
(Chandigarh)
7) BASED ON SYSTEM
Allopathic hospitals
System Ayurvedic hospitals
Homeopathic hospitals
Unani hospitals
Allopathic Hospitals:
It is a science based modern medical treatment such as surgery, medication & therapies
Ayurvedic Hospitals:
It include herbal medicine, special diets, yoga & massages
Homeopathic Hospitals:
It is a medical system based on the belief that the body can cure itself
Unani Hospitals:
It uses holistic & balanced approach. It focus on treating the whole person not just the symptoms
of the diseases.
ROLE PERCEPTION OF HOSPITALS
The important factors which led to the changing role & functions of the hospital
Improved economic & social status of the community
Control of communicable disease & increase in chronic degenerative diseases
Progress in the means of communications & transportation
Political obligation of the government to provide comprehensive health care
Increasing health awareness
Rising standard of living (in urban areas) & socio-political awareness (in semi urban &
rural areas)
Control & promotion of quality of care & professional associations
Increase in specialisation where need for team approach to health
Rapid advances in medical science & technology
Increase in population requiring more number of hospital beds
Sophisticated instrumentation, equipment & better diagnostic & therapeutic tools
Advances in administrative procedures & management techniques
Reorientation of the health care delivery system with emphasis on delivery of primary
health care
Awareness of the community
HOSPITAL AS A SYSTEM
A hospital can be variously described as a
Factory
Office building
Hotel
Eating establishment
Medical care agency
Social service institution
Business organisation
A system is viewed as anything formed of parts placed together into a cohesive whole
Every system is a part of large system & has its own subsystem
A system is having inputs which undergo certain processing & get transformed into output
Output send feedback to the input & the process, which can be altered to achieve better
output
A system is a continuous & dynamic phenomenon
Transformation of matter, energy to produce the output by 2 processes
The process of deciding what to do, how best to do it, when to do it
The process of putting the above decisions in action
PECULIARITIES OF A HOSPITAL SYSTEM
A hospital is a open system which interacts with its environment
A system has boundary, the boundaries separating the hospital system from other social
system are not clear
A system must produce enough outputs through use of inputs. Output of a hospital system
is not clearly measurable
A hospital system has to be in a dynamic equilibrium
The hospital system tends to become more specialised in its elements & elaborate in
structure
Anand views the system from 4 different perspectives
Client - oriented perspective - Access to service, use of service, quality of care and
maintenance of client autonomy & dignity
Provider - oriented perspective - Physician , nurses & other professionals working
for the hospital, Freedom of professional judgement & activities and maintenance of
proficiency & quality of care
Organisation - oriented perspective - Covers cost control, control of quality,
efficiency, ability to attract employee & staff and mobilisation of community support
Collective orientation perspective - It includes proper allocation of resources among
competing needs, representation of interests affected by the organisation and
coordination with other agencies.
