Hospital types and functions | What are the main types of hospitals?
The word "hospital "derived from the Latin word hospitalis which in turn derived from french word "hospes" that means " a host or a guest" A hospital is a health care institution providing treatment to patients with specialized staff and equipment.
Hospitals are institutions ,which are mainly designed for care for the sick ,injured and well.
DEFINITION:- Hospital is an integral part of a social and medical organization ,the functions of which is to provide for the population complete health care both curative and preventive, and whose outpatients services reach out to the family and its home environment. The hospital is also a centre for the training of health worker and for bio social researches.
FUNCTIONS OF HOSPITAL
FUNCTIONS OF THE HOSPITAL
1) Patient care
Diagnosis and treatment of disease
Out patient services
Medical education and training
Medical and nursing research
Prevention of disease and promotion of health.
CLASSIFICATION OF HOSPITALS :
CLASSIFICATION OF HOSPITALS
They classified according to,
• Length of stay of the patient
• Clinical basis
•Ownership /control basis
• System of medicine
1) Length of stay -
1) Short term
2) Long term
2) Clinical basis specialty -
1) Based on ownership
Voluntary nursing homes
1) Based on objectives
Teaching cum research hospitals
1) Based on size
1) Based on system
Allopathic hos pitals
Size of the hospital
The size of a district hospital is a function of the hospital bed requirement which in turn is a function of the size of the population it serves. In India the population size of a district varies from 50,000 to 15,00,000. For the purpose of convenience the average size of the district is taken in this document as one million population. Based on the assumptions of the annual rate of admission as 1 per 50 population and average length of stay in a hospital as 5 days, the number of beds required for a district having a population of 10 lakhs will be as follows:
The total number of admissions per year
= 10,00,000 × 1/50 = 20,000
Bed days per year = 20,000 × 5 = 100,000
Total number of beds required when occupancy is
100% = 100000/365 = 275 beds
Total number of beds required when occupancy is
80% = 100000/365 × 80/100
= 220 beds
Requirement of bedsin a District Hospital would also be determined by following factors: Urban and Rural demographics and likely burden of diseases
1) Geographic terrain
2) Communication network
3) Location of FRUs and Sub-district Hospitals in the area
4) Nearest Tertiary care hospital and its distance & travel time
5) Facilities in Private and Not-for profit sectors
6) Health care facilities for specialised population–
7) Defence, Railways, etc.
Area and Space norms of the hospital
Minimum Land area requirement are as follows:
Upto 100 beds = 0.25 to 0.5 hectare
Upto 101 to 200 beds = 0.5 hectare to 1 hectare
500 beds and above = 6.5 hectare (4.5 hectare for
hospital and 2 hectare for residential)
Size of hospital as per number of Beds
a. General Hospital - 80 to 85 sqm per bed to calculate
total plinth area. (Desirable).
The area will include the service areas such as waiting
space, entrance hall, registration counter etc. In
addition, Hospital Service buildings like Generators,
Manifold Rooms, Boilers, Laundry, Kitchen and essential
staff residences are required in the Hospital premises.
In case of specific requirement of a hospital, flexibility
in altering the area be kept.
b. Teaching Hospital - 100 to 110 sqm per bed to
calculate total plinth area.
Following facilities/area may also be considered
while planning hospital.
(i) Operation Theatre a. One OT for every 50
general in-patient beds
b. One OT for every 25
(ii) ICU beds = 5 to 10 % of total beds
(iii) Floor space for each ICU
= 25 to 30 sq m (this includes
(iv) Floor space for Paediatric ICU beds
= 10 to 12 sq m per bed
(v) Floor space for High Dependency Unit (HDU)
= 20 to 24 sq m per bed
(vi) Floor space Hospital beds (General)
= 15 to 18 sq m per bed
(vii) Beds space = 7 sq m per bed.
(viii) Minimum distance between centres of two beds
= 2.5 m (minimum)
(ix) Clearance at foot end of each bed
= 1.2 m (minimum)
(x) Minimum area for apertures (windows/ Ventilators opening in fresh air)
= 20% of the floor area (if on same wall)
= 15% of the floor area (if on opposite walls)
Site selection criteria
In the case of either site selection or evaluation of adaptability, the following items must be considered: Physical description of the area which should include bearings, boundaries, topography, surface area, land used in adjoining areas, drainage, soil conditions, limitation of the site that would affect planning, maps of vicinity and landmarks or centers, existing utilities, nearest city, port, airport, railway station, major bus stand, rain fall and data on weather and climate.
Factors to be considered in locating a district
1) The location may be near the residential area.
2) Too old building may be demolished and new construction done in its place.
3) It should be free from dangers of flooding; it must not, therefore, be sited at the lowest point of the district.
4) It should be in an area free of pollution of any kind including air, noise, water andland pollution.
5) It must be serviced by public utilities: water, sewage and storm-water disposal,electricity and telephone. In areas where such utilities are not available, substitutes must be found, such as a deep well for water, generators for electricity and radio communication for telephone.
6) Necessary environmental clearance will be taken.
Site selection Process
A rational, step-by-step process of site selection occurs only in ideal circumstances. In some cases, the availability of a site outweighs other rational reasons for its selection, and planners and architects are confronted with the job of assessing whether a piece of land is suitable for building a hospital.
In the already existing structures of a
1) It should be examined whether they fit into the design of the recommended structure and if the existing parts can be converted into functional spaces to fit in to the recommended standards.
2) If the existing structures are too old to become part of the new hospital, could they be conver- ted to a motor pool, laundry, store or workshop or for any other use of the district hospital.
3) If they are too old and dilapidated then they must be demolished. And new construction should be put in place.
Hospital Building – Planning and Lay out
Hospital Management Policy should emphasize on hospital buildings with earthquake proof, flood proof and fire protection features. Infrastructure should be eco-friendly and disabled (physically and visually handicapped) friendly. Local agency Guidelines and By- laws should strictly be followed.
i) Appearance and upkeep
1) The hospital should have a high boundary wall with at least two exit gates.
2) Building shall be plastered and painted with uniform colour scheme.
3) There shall be no unwanted/outdated posters pasted on the walls of building and boundary of the hospital.
4) There shall be no outdated/unwanted hoardings in hospital premises.
5) There shall be provision of adequate light in the night so hospital is visible from approach road.
6) Proper landscaping and maintenance of trees, gardens etc. should be ensured.
7) There shall be no encroachment in and around the hospital.
1) The building should have a prominent board displaying the name of the Centre in the local
2) language at the gate and on the building.
3) Signage indicating access to various facilities at strategic points in the Hospital for guidance of he public should be provided. For showing the directions, colour coding may be used.
4) Citizen charter shall be displayed at OPD and
5) Entrance in local language including patient rights and responsibilities.
6) Hospital lay out with location and name of the facility shall be displayed at the entrance.
7) Directional signages for Emergency, all the
8) Departments and utilities shall be displayed app- ropriately, so that they can be accessed easily.
9) Florescent Fire Exit plan shall be displayed at each floor.
10) Safety, Hazard and caution signs displayed prominently at relevant places.
11) Display of important contacts like higher medical centres, blood banks, fire department, police, and ambulance services available in nearby area.
12) Display of mandatory information (under RTI Act, PNDT Act, MTP Act etc.).
ii) General Maintenance
Building should be well maintained with no seepage, cracksin the walls, no broken windows and glass panes.
There should be no growth of algae and mosses on walls
etc. Hospital should have anti-skid and non-slippery floors.
iv) Condition of roads, pathways and drains
Approach road to hospital emergency shall be
all weather motorable road.
Roads shall be illuminated in the nights.
Tags: Study Notes