BHA-FXP4002, Emilia Bagiryan, assessent 1, attempt 1

1 Evolution of the Hospital Industry: A Comparative Analysis Emilia Bagiryan Capella University BHA-FPX4002: History of the United States Health Care System Dr. Shad Smith July 21, 2023

2 Evolution of the Hospital Industry: A Comparative Analysis Throughout history of the U.S. healthcare we have seen many changes within our hospital Industry. Those changes are drastically affecting the way patients are being treated. This paper will briefly talk, compare and contrast about evolution of healthcare and hospital industry. The comparison will be regarding healthcare quality in 1800’s, 1960’s and nowadays. It will elaborate on changes of hospital environment, level of care, required education of staff, and payment methods. Hospital Care Evolution In early 1800’s Hospitals were mainly viewed as a place to die. In that time frame people with contagious diseases, such as cholera, were only isolated in rooms and not treated due to lack of required knowledge of medical staff, as well as equipment. No hygiene methods were present either (Delgado, 2011). In 1960’s hospitals were equipped with specific equipment necessary for treatment procedures of various diagnosis, which also required special expertise from nurses. Air conditioning and hygiene, sanitation protocols in place (Delgado, 2011). Nowadays hospitals are more equipped with specialized equipment necessary to perform complex procedures such as dialysis or radiation therapies. Strict hygiene protocols and sterile procedures in place. Hospices and nursing home options available for those who suffer with terminally ill disorders. Patient comfort and safety is highly prioritized (Delgado, 2011) Hospital Environment In 1800’s hospitals were mostly used to shelter contagious people. They were not treated but just kept isolated. No proper ventilation, or hygiene methods were present, therefore, patients struggled with infections. In 1960’s hospital environment were comparably better with improved ventilation, lighting, electrical beds and improved hygiene. Services such as X-rays, and

4 medical establishments and practise. Doctor’s education level became more intense and heavily regulated, thus increasing level of care for the patient. Paying for Your Care In early 1800’s doctors were paid by small amounts of cash or services and goods, such as food, wine, etc. In 1960’s implementation of Medicare and Medicaid happened, where government would pay for the majority of the cost of medical services. Medicare would be given to qualified people older than 65 years old and to people with disabilities. Medicaid would cover low-income people who qualify for the assistance (Kroth and Young, 2018). Even nowadays Medicare and Medicaid insurances continue to help population with medical payments. In addition to those we also have private insurances that help with cost coverage. Therefore nowadays medical payments are not solely only patient’s responsibility. Comparative Analysis As discussed earlier, healthcare has grown dramatically since 1800’s. There were no formal education established in 1800’s, but now all physicians are required to go through four years of standardized medical school and additional residency years based on specialty. In 1800’s payments were not only in monetary ways, but also goods and services. Now health insurances cover majority of the cost. During 1960’s establishment of doctors’ extensions such as NP/PA’s happened(first class of PA’s in 1965). Now PA’s and NP’s have significant role in healthcare aiding in shortage of doctors and primary care providers, making healthcare more accessible in rural areas. Hospitals now are being viewed as a place for skilled medical emergencies, rather than a place to be isolated and left to die (Berslaw, 2012). Conclusion

5 In conclusion, healthcare industry has drastically changed since 1800’s to nowadays. Level of staff education, hospital environment, and level of care showed significant progress compared to 1800’s where disorders were believed to be caused from “the evil”(Berslaw, 2012). As history shows, advancement of research studies and technologies, helps physicians practice evidence-based medicine, which is a field that never stops growing. Technologies advance, new medications enter the market, new research articles are being published with new treatment methods of existing conditions, and hopefully it will continue to grow towards the best, in order to maximize patient experience in receiving appropriate medical care with minimal errors.

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 the course resources for this assessment or your own research, and document where you found the information using accurate APA citations. Subject/Topic 1800s 1960s 2000s Hospital Environment (Describe the overall hospital environment.)  Care mostly provided at the patient’s residence (Berslaw, 2012)  Hospitals were sheltering/isolating sick, rather than treat (Berslaw, 2012)  Treatment was provided at the Physician’s office (Kroth & Young, 2018)  Hospital facility improvement with lighting, ventilation, hygiene (Kroth & Young, 2018)  Big structures of hospitals and contracted physicians (Kroth & Young, 2018)  Faster recovery and comfort of patient Medical Staff Education Level (Describe the care providers and their education levels.)  No formal education established  Began to have established education requirements  Nursing career was introduced (Kroth & Young, 2018)  PA, NP education  Stricter rules and requirements to practise as a physician(4 year of Medical school, followed by residency/fellowship for a specialty additional 3-7 years) (Kroth & Young, 2018) Level of Care (Describe the quality of care for each century and if it improved.)  Treatments were mostly consisted of home remedies or plants.  Care was provided at patient’s houses (Berslaw, 2012)  Hospitals were getting better equipment and diagnostic imaging methods to improve level of care (Kroth & Young, 2018)  Higher level care based on research studies  Inpatient and outpatient services provided  Advance equipment for dialysis, radiation, etc. (Kroth & Young, 2018) Paying for Care (Describe how care was paid for.)  Cash payments, or different goods such as food or other services in exchange to medical treatments (Allen, 2016)  Medicare and Medicaid program started in 1965  Health insurances were introduced  Fee for service reimbursement (Allen, 2016)  Health insurances/Medicare will cover most of the cost  Medicare Physician’s fee schedule  Out of pcoket payment possible  2010 affordable pay act was created (Allen, 2016)