Types of Hospitals (Classified according to the type of service)

A general hospital provides a variety of services, including general and specialized medicine, general and specialized surgery, and obstet­rics, to meet the general medical needs of the community it serves. It provides diagnostic, treatment, and surgical services for patients with a variety of medical conditions. Most hospitals in the United States are general hospitals.

It is important to note that the term “general hospital” does not imply that these hospitals are less specialized or that their care is infe­rior to that of specialty hospitals. The difference lies in the nature of services, not their quality. General hospitals provide a broader range of services for a larger variety of conditions; whereas specialty hospi­tals provide a narrow range of services for specific medical conditions or patient populations.

According to the North American Industry Classification System of the US Census Bureau, specialty hospitals are establishments that primarily engage in providing diagnostic and medical treatment to inpatients with a specific type of disease or medical condition, except services for psychiatric care or substance abuse. Specialty hospitals forge a distinct service niche. Traditionally, the two most common specialty hospitals have been rehabilitation hospitals and children’s hospitals. With increasing competition, however, other types of spe­cialty hospitals have emerged to provide treatments that are also avail­able in many general hospitals. Examples include orthopedic hospitals, cardiac hospitals, cancer (oncology) hospitals, and women’s hospitals. Physicians find such specialized hospitals more efficient, and in many instances, physicians are full or part owners of these hospitals.

The primary function of a psychiatric inpatient facility is to provide diagnostic and treatment services for patients who have psychiatric- related illnesses. Specifically, such an institution must have facilities to provide psychiatric, psychological, and social work services. Both state and private mental institutions continue to provide long-term treat­ment to people with severe and persistent mental illness. In 2004, the United States had 466 psychiatric hospitals.

Rehabilitation hospitals specialize in therapeutic services to restore the maximum level of functioning in patients who have suffered recent disability due to an episode of illness or an accident. These hospitals serve patients who generally cannot be cured but whose functioning can be improved. According to Medicare rules, to be classified as a rehabilitation hospital, 75 percent of hospital’s inpatients must require

intensive rehabilitation services for the treatment of stroke, spinal cord injury, major multiple trauma, brain injury, and other specific condi­tions. Rehabilitation hospitals also serve amputees and victims of ac­cidents or sports injuries. Patients often transfer to these facilities after orthopedic surgery in a general hospital. Facilities and staff are avail­able to provide physical therapy, occupational therapy, and speech and language pathology. Most rehabilitation hospitals have special ar­rangements for psychological, social work, and vocational services, and are required to have written arrangements with a general hospital for the transfer of patients who need medical, obstetrical, or surgical care not available at the institution.

Children's hospitals are community hospitals that typically have specialized facilities to deal mainly with complex, severe, or chronic illnesses among children. Nearly all children’s hospitals provide neo­natal intensive care units, pediatric intensive care units, trauma cen­tres, and transplant services. Thus, these hospitals provide a wide range of high-intensity services for children, such as pediatric surgery, car­diology, orthopedic surgery, cancer treatment, HIV/AIDS treatment, and rehabilitation services.

There are 48 freestanding children’s hospitals in the United States. They have an average capacity of 134 beds. All of these hospitals are non-profit, and are located in major metropolitan areas. Many are af­filiated with medical schools and academic medical centres. However, many large communities do not have specialty children’s hospitals. In these communities, general acute-care hospitals serve as de facto chil­dren’s hospitals by providing the same services and treating the same types of patients.

[ 3 ]Read the text about American hospitals classified according to the type of ownership. Be ready to compare public, voluntary hospitals and pro­prietary hospitals.