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Hospital types and functions | What are the main types of hospitals?

Hospital types and functions | What are the main types of hospitals?

Hospital types and functions | What are the main types of hospitals?

Hospitals in New Delhi: List of Blood Banks, Causalities and Ambulance in Delhi


Introduction 

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 
Objectives 
Size 
Management 
• System of medicine

Hospital - 

1) Length of stay - 
1) Short term 
2) Long term
2) Clinical basis specialty - 
1) General
2) Specialty

Hospital - 

1) Based on ownership
Public hospitals 
Voluntary hospitals 
Voluntary nursing homes 
Corporative hospitals

Hospital - 

1) Based on objectives
Teaching cum research hospitals 
General hospital 
Specialized hospitals 
Isolation hospitals

Hospital - 

1) Based on size 
Teaching hospital
 District hospital 
Thaluk hospital
 CHC
 PHC

Hospital - 

1) Based on system 
Allopathic hos pitals 
Ayurvedic hospitals 
Homeopathic hospitals 
Unani hospitals 
Other system

Physical Infrastructure

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 

Land Area
(Desirable)
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.
(Desirable)
(i) Operation Theatre a. One OT for every 50 
general in-patient beds
b. One OT for every 25 
surgical beds.
(ii) ICU beds = 5 to 10 % of total beds
(iii) Floor space for each ICU 
bed
= 25 to 30 sq m (this includes 
support services)

(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 

hospital
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 

district hospital
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.

ii) Signage

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.

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