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BHA4002
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Medicine
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Feb 20, 2024
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8
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1 Evolution of the Hospital Industry: A Comparative Analysis D’Angela Purnell
Capella University BHA4002: History of the United States Health Care System Professor Becky Stocker January 2024
2 Evolution of the Hospital Industry: A Comparative Analysis Hospitals have evolved to be better since the 1800s. This assessment will be a comparative analysis of the 1800s, 1960s, and 2000s on the evolution of hospitals in certain aspects. Hospitals have changed for the better since the 1800s from low patient care quality to high patient care quality. The hospital industry has become more patient-focused since the 1800s. This comparative analysis will discuss hospital care, hospital environment, staff education, level of care, and payment of care in these different eras. Hospital Care Evolution Hospital care has evolved in many ways from the 1800s to the 2000s in a positive way. Hospital care began as a family responsibility, and the hospital was the place to pass away. Innovative changes, such as medical technology, improvement in treatment methods, and patient-centered care, are significant reasons for improving hospital care. During the 1800s, proper medical care was not understood to provide high-quality patient care. As time went on, the 19th century began the start of improvements in the hospital and current-day advances on all levels of hospital care. Hospital Environment The hospital environment has changed drastically since the 1800s. In the early 1800s, hospitals were unsanitary and overcrowded, and poor hygiene led to the spread of infections. By the late 1800s, medical knowledge advanced, and training programs were established to improve the hospital environment. As time progressed, hospitals experienced changes like technological advancements and improved surgical techniques. During the 1960s, as improvements were made, other challenges continued, such as healthcare delivery because of burnout in staff. Today, hospital environments include a combination of advanced medical technology, evidence-based practices, and a highly patient-centered approach. Hospitals also prioritize cleanliness, infection control, and patient safety. Patient experience is the higher arch of hospital environments. While
3 the hospital environment has significantly advanced, it still faces challenges like healthcare disparities and resource allocation. Staff Education
During the early 18th century, physicians were not required to have a license to practice. As the 19th century progressed, the standardization of the medical school curriculum was established so that medical students could receive the proper education to practice. During WW2, 3-year programs were initiated to approach physician shortage, but questions arose about the programs due to physician competency. 1963 Health Professions Education Assistance Programs were implemented to support health professions. After HPEAP was implemented, federal legislations were passed for the improvement of education, such as the Allied Health Professions Personal Training Act (1966), Health Training Improvement Act (1970), Nurse Training Act (1971), and Comprehensive Health Manpower Training Act (1971). In the 2000s, physicians must successfully complete a program for their desired field of work to provide direct patient care. Level of Care During the 1800s, the beginning of hospital development, hospitals are used as places of refuge and an opportunity for patients to lend their bodies and illnesses to medical students (Johnson et al.). As time progressed, medical technology became more advanced in the 1900s, and healthcare improved. This improvement in healthcare led to the prevention and cures for many infectious diseases. Currently, hospitals provide both primary care and specialty care to service patients. Telemedicine was introduced to help broaden the delivery of care for patients, leading to a higher quality of care. Healthcare today provides continuum care for patients that are patient-centered with personalized approaches.
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4 Paying for Your Care During the 1800s, healthcare was usually paid out-of-pocket for medical services
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charity hospitals and clinics to use for those who could not afford private care. Healthcare insurance was not as widespread as it is in the present day. In the 1960s, healthcare payment methods evolved, and private and employer-sponsored insurance became popular to pay for care. Medicare and Medicaid were introduced in 1965 to provide support and coverage for the elderly and low-
income individuals. SCHIP was established following Medicare and Medicaid to provide subsidized health insurance coverage for low-income children. Today, healthcare payments are diverse. Many individuals use private insurance, employee-sponsored plans, or individual marketplaces to pay for care. Medicare and Medicaid are still prominent for specific populations. Out-of-pocket expenses are also still essential and common for paying for care. Comparative Analysis This comparative analysis examined the hospital industry's evolution from the 1800s to now. Based on the information gathered, in the 1800s, the hospital industry needed to be developed adequately to service patients correctly. It was primarily used for those who were poor and mentally unstable. In the 1960s, progression began on all levels of the hospital industry, leading to advanced technology, proper medical education, and patient-centered focus. The introduction of Medicare/Medicaid pushed for more access to healthcare for patients, which helped streamline the betterment of care provided because of the increase in patients. In the 2000s, hospitals have proven advanced on all levels to provide proper and high-quality patient care based on the information gathered. For example, hospitals have approaches to help individuals who have fully developed cancer; compared to the 1800s, there were no approaches or technology to fight cancer the way hospitals have technology today.
5 Conclusion In conclusion, hospitals and medical care have improved since the 1800s for the better. These improvements and the quality of care provided increased the life span of an individual. The evolution of the hospital and healthcare system has proven that advancements will always continue. It is essential to know the evolution and history of healthcare because it can lead to future improvements, give a clearer picture of what was and what is, and give us an appreciation in the present day for the quality of care provided. History helps us grow as a community, and history helps healthcare grow to provide better care for patients.
6 References Johnson, James A, et al. Sultz & Young’s Health Care USA :
Understanding Its Organization and Delivery
. 10th ed., Burlington, Ma, Jones & Bartlett Learning, 2023. Gruber, Jonathan, and Helen Levy. “The Evolution of Medical Spending Risk.” Journal of Economic Perspectives
, vol. 23, no. 4, Nov. 2009, pp. 25
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48, https://doi.org/10.1257/jep.23.4.25
. Accessed 15 Nov. 2019. Schwartz, Christine C., et al. “Comprehensive History of 3
-Year and Accelerated US Medical School Programs: A Century in Review.” Medical Education Online
, vol. 23, no. 1, Jan. 2018, p. 1530557, https://doi.org/10.1080/10872981.2018.1530557
. UC Davis Health. “History of the Hospital 1870s
-90s, Celebrating 150 Years at Stockton Blvd and X St, UC Davis Medical.” Health.ucdavis.edu
, health.ucdavis.edu/aboutus/150th-
anniversary/articles/history-of-the-hospital.html. Z, Behrouz, et al. “The Evolution of American Hospitals.” Digital Antidote
, 11 Feb. 2018, bzandmd.wordpress.com/2018/02/11/the-evolution-of-american-hospitals/. Center for the History of Medicine. “Medical Treatment in the Nineteenth Century · Jars of “Art and Mystery”: Pharmacists and Their Tools in the Mid
-Nineteenth Century · OnView: Digital Collections & Exhibits.” Collections.countway.harvard.edu
, collections.countway.harvard.edu/onview/exhibits/show/apothecary-jars/nineteenth-
century-treatment. Zinner, Michael J., and Kevin R. Loughlin. “The Evolution of Health Care in America.” The Urologic Clinics of North America
, vol. 36, no. 1, 1 Feb. 2009, pp. 1
–
10, v, pubmed.ncbi.nlm.nih.gov/19038631/, https://doi.org/10.1016/j.ucl.2008.08.005
.
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7 Appendix Comparative Analysis Table: Hospital Care Evolution
Instructions:
Fill in the chart with bullet points that describe the key milestones (events, regulations, laws, etc.) and the supporting details to explain the topics in each cell. Use your textbook and at least two other resources from Week 2’s What You Need to Know in your research, and document where you found the information using accurate APA citations. Subject/Topic
1800s
1960s
2000s
Hospital Environment (Describe the overall hospital environment.) •
Hospitals were unsanitary and overcrowded •
Used as a place for the poor and mentally unstable were kept to die •
Hospitals became more sanitary and safer for surgeries and care •
Technology advances in healthcare making hospitals more vital for care •
Doctors are trained for primary care services and specialty care services •
Hospitals provide emergency care to patients •
Hospitals are equipped with the best technology and staff to service patients for high quality care Medical Staff Education Level (Describe the care providers and their education levels.) •
Standardization of the medical school curriculum •
3-year medical programs initiated due to physician shortage
•
Physicians are not required to be licensed
•
Health Professions Education Assistance Programs were implemented to provide support for the health professions. •
Federal legislations were passed (1965-
1971) •
Doctors and nurses are required to have licenses to practice •
Renewal of 3-year programs due to physician shortage and high student debt •
75% of US medical schools initiated innovative pedagogy Level of Care (Describe the quality of care for each century and if it improved.) •
Medical practices relied on symptomatic treatment •
Drugs were classified by the physiological effects •
Surgery during the 1800s was unsafe due to exposure to infections •
Medical advancement led to prevention or cure of many infectious diseases •
Hospitals are equipped with high technology, newer drugs and more creative surgical procedures •
Hospitals service primary care and specialty care services for patients
8 •
Telemedicine introduced for the delivery of healthcare Paying for Care (Describe how care was paid for.) •
Health insurance did not exist •
Accident insurance was used to help people financially who were injured •
Medical costs were expected to be paid directly by the patients •
Establishment of Medicare for the elderly and Medicaid for the poor •
Establishment of SCHIP to provide subsidized health insurance coverage for low-income children •
SCHIP is expanded to children in higher-
income groups
•
By law, hospitals receiving federal funding are required to treat patients with emergency conditions regardless of insurance status
•
Multiple forms of payment accepted for treatment that include cash, debit/credit, insurance