WEEK 2 BHA 2.0
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Medicine
Date
Dec 6, 2023
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1
Evolution of the Hospital Industry: A Comparative Analysis
Allie Hancock
Capella University
BHA4002: History of the United States Health Care System
Sharlene Krause
10/22/2023
2
Evolution of the Hospital Industry: A Comparative Analysis
In this comparative analysis report, we will discuss the evolution of the hospital industry
between the 1800s and 2000s. This research was performed to show the significant changes over
100 years. They range from treatment, staffing, education, and cost. Due to science, not only has
the hospital industry improved, but so has healthcare.
Hospital Care Evolution
In the 19
th
century, hospitals were funded by wealthy citizens who donated money as part
of their civic duties. During these times, they treated people experiencing poverty but had little
medical treatment. Surgeries were unsafe due to rampant infection, and physicians used patients
to do trial runs for treatment. Between the 1800s and 2000s, there were medical scientific that
helped improve the hospital industry, and those included Sterilization, founded by Joseph Lister
in 1867; Xray, founded by German Physicist Wilhelm Roentgen, 1960 when heart catheterization
was used to see blocked arteries; and by 1970s were opening them up. A significant hospital
transformation happened in 1965 with the passage of the Social Security Amendment of 1965,
which created Medicaid and Medicare. In 2012, $970 Billion of healthcare expenditures went
into the 4,895 acute care hospitals. Today, American Hospitals are the dominant players in the
healthcare system, significantly impacting the American economy.
Hospital Environment
During the early 1800s, hospitals were limited with treatments, beds, testing, and staff.
For most of the 19
th
century, only the socially marginal, poor, or isolated received medical care in
institutions in the United States. Between 1865 and 1925, in all regions of the United States,
hospitals transformed into expensive, modern hospitals with x-rays, laboratories, and antiseptic
surgeries with their technical equipment and specialized personnel.
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Staff Education
During the medieval and early Renaissance eras, universities in Italy and Germany
became centers for the education of medical practitioners. 1859 Florence Nightingale established
her famous nursing school at St. Thomas Hospital in London. Nursing education began to move
from a 3-year hospital-based diploma program to 4-year baccalaureate programs in the 1900s
through the contributions from William Osler, Abraham Flexner, and the Establishment of the
American Medical Association (AMA) Council of Medical Education (CME). By 1980,
premedical science requirements had become established, including two semesters of general
chemistry, physics, and biology and one semester of organic chemistry. In the early twentieth
century, medical education was guided by Abraham Flexner and William Osler. Flexner
recommended that medical schools be university-based, have minimal admission requirements,
and implement a rigorous curriculum with applied laboratory and clinical science content. Osler
championed bedside teaching, bringing medical students into direct contact with patients and
learning medicine from these direct experiences under the guidance of faculty clinicians.
Level of Care
During the 19
th
century, the environment in the common areas of the hospitals was filthy,
and the spread of disease became rampant. Before medical science was founded, patients sought
care at home, with home remedies and performing surgeries. The physicians were not paid but
instead volunteered to gain practice. Treatment was limited due to insufficient knowledge,
treatments, and testing. Dr. Emil Freireich, along with colleagues, achieved cures using
combination chemotherapy. Due to advanced technologies in the 1900s to early 2000s, hospitals
were able to treat many human diseases. More knowledge was gained through practice, and it
rapidly grew.
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4
Paying for Your Care
In 1965, Medicaid and Medicare were established by the Social Security Amendment,
extending health coverage to almost all Americans aged 65 or older and providing healthcare
services to low-income families and people with disabilities. In 1966, Medicare was
implemented, more than 19 million enrolled, and the Balanced Budget Act was created. Private
insurance spread throughout the U.S. from 1930 to the 1960s. The enactment of the Health
Professions Educational Assistance Act of 1963 provided direct financial assistance to medical,
dental, nursing, and pharmacy. During the 20
th
century, President Obama signed the Affordable
Care Act, and Health coverage became more accessible to patients.
Comparative Analysis
During the 1800s, hospital care was minimal. Low-income patients were seeking care at
home, performing surgeries at home, and seeking home remedy treatments. Wealthy people
funded hospitals, staff was limited with a lack of knowledge and expertise, and treatment was
unfeasible. Being uninsured was part of the reason some did not have access to health care.
Between the 1860s and 2000s,
medical science helped improve not only the staff's
knowledge but also the patients' treatment. Significant changes happened between 1865 and
1925 when hospitals in all regions of the United States transformed into modern hospitals of
science and technology. During 1925, these hospitals functioned with the advantages of x-rays,
laboratories, aseptic surgeries, specialized personnel, technical equipment, and access to
insurance coverage and financial help.
Conclusion
In conclusion, the Evolution of Healthcare has significantly changed throughout the past
100 years and continues to grow. With the changes and additions to healthcare, people have a
5
higher quality of life and can seek the care they need when they fall ill. As healthcare continues
to expand rapidly, the more positive changes will continue. In healthcare, things change daily as
new medications, treatments, and technology are created for many diagnoses. As we all know,
when COVID-19 hit, there was an issue with access to health care due to the safety of the staff
and patients. The pandemic created Telemedicine, which made seeking care during a crisis more
accessible and still allows patients to receive treatment.
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References
(Include at least three resources, all of which must be cited in the body of your paper.)
BEHROUZ ZAND, M.D., M.S.
THE EVOLUTION OF AMERICAN HOSPITALS
(FEBRUARY 11
TH
, 2018).
The Evolution of American Hospitals – Digital Antidote (wordpress.com)
Christine C. Schwartz
,
Aparna S. Ajjarapu
,
Chris D. Stamy
,
and
Debra A. Schwinn
A comprehensive history of 3-year and accelerated U.S. medical school programs: a century in
review - PMC (nih.gov)
Buja, L.M. Medical education today: All that glitters is not gold.
BMC Med Educ
19
, 110 (2019).
https://doi.org/10.1186/s12909-019-1535-9
https://rdcu.be/dpaMh
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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.)
1867 was the birth
of Sterilization
(Joseph Lister)
Xrays were
created (Wilhelm
Roetgen)
Treatments and
surgery were
performed at home
Education lacking
in the personnel
Only the socially
marginal, poor, or
isolated received
care in institutions
Medical science
and technology
expanded
(Laboratories,
aseptic surgeries,
diagnostic testing)
Hospitals turned
into Modern
hospitals of Science
and Technology
Hospitals
expanded across
the U.S.
Cures were
founded
Technology was
created
More
accessibility
Medical Staff
Education
Level
(Describe the
care providers
and their
education
levels.)
Universities in
Italy and Germany
became centers for
the education of
medical
practitioners.
Famous nursing
school at St.
Thomas
Hospital(Florence
Nightingale)
3-year hospital-
based diploma
programs switched
to 4 year
baccalaureate
programs
Education
requirements
have become
more accessible.
New technology
and science
created new
knowledge
Level of Care
(Describe the
quality of care
for each century
and if it
improved.)
Spread of disease
was rampant.
Care was
performed at
home.
Lack of treatment
Performing Heart
Catheterizations
Intensive Care
Units Opened
Specialized
personnel
New Technology
Expanding
hospitals
More accessible
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Paying for
Care
(Describe how
care was paid
for.)
Free Clinics
Home procedures
Medicare and
Medicaid were
created.
Social Security
Amendment
Insurance
Medicare and
Medicaid
Financial
Assistance