INTRODUCTION TO HOSPITAL & ITS CHALLENGES

-Dr.Sharad H.Gajuryal

Junior Resident

MD( Hospital Administration)

BPKIHS,Dharan

INTRODUCTION

Hospitals are the institution providing medical & surgical treatment and nursing care for any ill or injured people.

It is an intregal part of social and medical organization, The function of which is to provide complete health care to the needy one, both curative and preventive.It is also a center for providing training to health workers & center for biosocial research(WHO)

Hospitals are the part of social system which again have subsystem like clinical services, Diagnostic services, Therapeutic Services, supportive and utility services with heterogeneous group of people like Doctors, Nurse ,Paramedics ,Administrative staffs all working together to provide medical care to patients.

HISTORY

The word “Hospital” originated from Latin word “Hospice” ,meaning of which is guest. The medieval Latin word “Hospitale” means the place for reception of guest which have mainly six types of institutional meanings, one of which is “ An institution that care for sick, injured and wounded”

In early period during greek and roman civilizations,Temples were used as hospitals. With birth of christianity, Churches were also used as hospitals.

The Earliest noted Hospital was

HOTEL DIEU,PARIS 542 AD

St.BARTHOLOMEU’S HOSPITAL,LONDON 1123AD

SPANISH HOSPITAL,MEXICO CITY,1524 AD

FIRST GENERAL HOSPITAL,NORTH AMERICA(PENNSYLVANIA HOSPITAL) 1715AD

MASSACHUSETTS HOSPITAL 1811 AD

The advance in all field of medical science led to experimental growth in hospital service.

LEGAL STATUS OF HOSPITAL

Generally 3 types of legal status

Public hospital NGO run Hospital Private hospital

Public Hospital : They are directly under govermental control. They can be categorized as

- Sole government hospital- Semi-Autonomous hospital- Autonomous hospital

Sole Government Hospital are manged by civil servant. The fee /Income directly goes to government treasury and have direct control of government.

Semi Autonomous Hospital- Run and managed under Development committee Act. Government constitutes a development committee accourding to the act and committee is responsible for managing hospital, fix fees, appointing staffs (under dev. Committee only) . Government also send civil servants to manage semi-autonoomous hospital. Eg- Kanti Children Hospital, Maternity Hospital etc.

Autonomous Hospital –These kinds of hospitals are established, run and managed under separate act for individual hospital. The governing body is the apex body to manage and run hospital. Eg. BPKIHS, Gangalal Heart center

Public hospitals also can be catagorized into purely Civil hospital (kanti children hospital ), For Service personel (Police, Army Hospital ), and education institute (BPKIHS,TUTH etc)

2. NGO run hospital : They are non profit and social organization and

are part of social service. These hospitlas must be registered in concerned District administration office and social walfare council for legal validity.

They also must take permission from Ministry of Health to establish and run hospital

Eg-Mission haospital, Palpa. Scheer Memorial Hospital etc.

3. Private Hospital- These Hospitals are run by private sectors and must be registered under company act in the company Registrat’s office.

They may be Proprietary Hospital or Private Limited Hospital or Limited Hospital.

They must take permission from Ministry of Health to establish run and manage hospitals.

TYPES AND CLASSIFICATIONS OF HOSPITAL

According to the definition given by WHO , all hospital will not qualify to called a Hospital. Because there are wide range of Hospital. Some are big, some small, some imparting teaching & training activities and some with mixed facilities. So Hospitals can be categorized and classified in different manners.

1. According to Ownership: Public Hospital NGO run hospital Private Hospital

2. According to Objectives: General Hospital Speciality Hospital Teaching –cum- research Hospital

3. According to System of Medicine Allopathic Hospital Ayurvedic Hospital Homeopathic Hospital Unani Hospital

4. According to Level of Care Primary care Hospital eg.PHC Secondary care Hospital eg.Dist. Hospital Tertiary care Hospital eg. Regional Hospital

5. According to size of Hospital Health Centers District Hospitals Zonal Hospitals Regional Hospitals Central Hospital

6. According to Teaching facility Teaching Hospital Non-Teaching Hospital

FUNCTION OF HOSPITAL

Curative or medical care Preventive care Promotive care Rehabitative care Education and training Research

HOSPITALS IN 21ST CENTURY

The hospitals have travelled a long journey from a time when hospitals were used to be synonym to temples or home where people go to take complete rest and wait till death.

Today hospital are a hi-tech organizations, If a patient recalls his hospital stay he will have memory of being surrounded by electronic gadgets, hi tech equipments ,doctors , nurse with computer, notebook , pen drives and every thing being processed with computers

In past, the aim of hospital was to provide care, comfort and assurance to the patient with team of dedicated doctors , nurses and other staffs whose aim was never uopn to earn money but to serve the poor, helpless and destitute.

The doctors were treated as god and patient were treated as guest or angels of god.

Due to rapid development and advancement of technology, influence of money in lives of people, policy of government, Health insurance, medical tourism etc have changed total scenario of hospital in new millennium.

The shift is from care of sick and treating the patient as an agent of god to treating patient as customer and providing quality care which is need based as developing the hospitals as center of excellence and profit making organizations.

CHALLENGES TO HOSPITALS

Changes in Pay Structure i.e high costs Quality Services Management by clinicians in Bureaucratic

way Lack of trained and professional manpower Awareness of clients to rights and obligations Patient Satisfaction Legislation in the helth care.