Hosp Functions

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HospitalsHospitals Roles andRoles and

FunctionsFunctions

Dr Amit M PatilDr Amit M PatilMr. Deepak PedhurkarMr. Deepak Pedhurkar

DHA 2010DHA 2010


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IntroductionIntroduction

Hospitals are an important component of healthHospitals are an important component of health

care system.care system.

Their importance within the health care systemsTheir importance within the health care systems

can be due to following reasonscan be due to following reasons

a.a. They account for substantial proportion of healthThey account for substantial proportion of health

care budget.care budget.

b.b. Policies they adopt has a major impact on overallPolicies they adopt has a major impact on overall

health care.health care.

c.c. Technological and pharmaceutical developmentsTechnological and pharmaceutical developments

along with evidence based managementalong with evidence based management

contribute significantly to population health.contribute significantly to population health.


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Definition of HospitalDefinition of Hospital

A hospital is an integral part of a social and A hospital is an integral part of a social and

medical organization, the function of which is tomedical organization, the function of which is to

provide for the population complete healthprovide for the population complete health

care, both curative and preventive, and whosecare, both curative and preventive, and whose

outpatient services reach out to the family andoutpatient services reach out to the family and

its home environment.its home environment.WHOWHO


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Types of hospitalsTypes of hospitals

A.A. Based on bed strengthBased on bed strength

i. Smalli. Small less than 100 beds.less than 100 beds.

ii. Mediumii. Medium 100 to 500 beds.100 to 500 beds.

iii. Largeiii. Large More than 500 beds.More than 500 beds.

B.B. Based on services renderedBased on services rendered

i. General servicesi. General servicesii. Specialityii. Speciality

iii. Super specialityiii. Super speciality


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C.C. Based on funding bodyBased on funding body

i.i. GovernmentGovernment

ii. Municipalii. Municipal

iii. Trustiii. Trust

iv. Specific Communityiv. Specific Communityv. Privatev. Private

D.D. Revenue generationRevenue generation

i.i. FreeFree

ii. Corporateii. Corporate

C.C. Teaching and non teaching hospitals.Teaching and non teaching hospitals.


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Differences between hospital and productionDifferences between hospital and production

industryindustry

FeaturesFeatures HospitalHospital IndustryIndustry

Raw materialRaw material HumanHuman Non humanNon human

Desired end productDesired end product HumanHuman Non humanNon human

StandardizationStandardization Not possibleNot possible Always carried outAlways carried out

ActivitiesActivities VariableVariable Well definedWell defined

ServicesServicesC

ontinuous, emergencyC

ontinuous, emergency Specified timeSpecified time

Time scheduleTime schedule Round the clockRound the clock Specified timeSpecified time

Duty scheduleDuty schedule Difficult workloadDifficult workload Controlled work loadControlled work load


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Differences contdDifferences contdFeaturesFeatures HospitalHospital IndustryIndustry

StaffStaff Varied personnelVaried personnel Each section has personsEach section has persons

of similar statusof similar status

AuthorityAuthority Multiple li nes of controlMultiple lines of control Vertical lineVertical line

Cooperation, coordinationCooperation, coordination EssentialEssential UsefulUseful

Performance appraisalPerformance appraisal Difficult to quantifyDifficult to quantify Easy to measureEasy to measure

Conflicts and tensionsConflicts and tensions FrequentFrequent Can be controlledCan be controlled

Services of doubtfulServices of doubtful

benefitsbenefits

May continueMay continue Can be stoppedCan be stopped


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Transformations in Health CareTransformations in Health Care

FromFrom ToTo

Health careHealth care Sick careSick care

Provider drivenProvider driven Buyer drivenBuyer driven

Sacred faith in doctorSacred faith in doctor DistrustDistrust

Do what seems bestDo what seems best Activities based on paymentActivities based on payment

Service industryService industry Corporate industryCorporate industry

General routine careGeneral routine care Specialized, sophisticated careSpecialized, sophisticated care

Low costLow cost High costHigh cost

Highly ethicalHighly ethical Highly technologicalHighly technological


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Components of HospitalComponents of Hospital

A.A. Hard wareHard ware

BuildingBuilding

FurnitureFurniture

EquipmentEquipment

MaterialsMaterials Consumable/Non consumableConsumable/Non consumable


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B.B. Soft wareSoft ware

a. Staffa. Staff

SkilledSkilled

SemiskilledSemiskilled

UnskilledUnskilled

b. Patientsb. Patients

PresentPresent PotentialPotential


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Functions of a HospitalFunctions of a Hospital

Functions

Patient care

Research

Employment

Societal

HealthSystemsupport

Teaching


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A.A. Medical care of sickMedical care of sick

1.1. Inpatient, out patient and day careInpatient, out patient and day care

2.2. Emergency and electiveEmergency and elective

3.3. RehabilitationRehabilitation

B.B. Prevention of diseasesPrevention of diseases1.1. Promotion of healthPromotion of health

2.2. Early diagnosis and treatmentEarly diagnosis and treatment

3.3. Primary and secondary prevention.Primary and secondary prevention.


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C.C. EducationEducation

1.1. UndergraduateUndergraduate

2.2. PostgraduatePostgraduate

3.3. Continuing educationContinuing education

4.4.

VocationalVocationalD.D. ResearchResearch

1.1. Basic researchBasic research

2.2. Clinical researchClinical research

3.3. EducationalEducational

4.4. Health service researchHealth service research


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E.E. Health system supportHealth system support

1.1. Source for referralsSource for referrals

2.2. Professional leadershipProfessional leadership

3.3. Base for out reach activitiesBase for out reach activities

4.4.

Management of primary careManagement of primary careF.F. Social functionsSocial functions

1.1. State legitimacyState legitimacy

2.2. Political symbolPolitical symbol

3.3. Provider of social careProvider of social care

4.4. Base for medical powerBase for medical power

5.5. Civic prideCivic pride


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G.G. EmploymentEmployment

1.1. Inside hospitalInside hospital

Health care professionalsHealth care professionals

Other health care workersOther health care workers

2.2. Outside hospitalOutside hospital SuppliersSuppliers

Transport servicesTransport services

OthersOthers


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A.A. Medical care of sickMedical care of sick

1.1. Inpatient, out patient and day careInpatient, out patient and day care

Indoor servicesIndoor services

Out patient servicesOut patient services

Day care servicesDay care services2.2. Emergency and elective servicesEmergency and elective services

Emergency careEmergency care

Emergency care in disaster situationsEmergency care in disaster situations

Elective careElective care


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3.3. RehabilitationRehabilitation defined asdefined as

the combined and coordinated use of medical, the combined and coordinated use of medical,

Social, educational and vocational measures forSocial, educational and vocational measures for

training or retraining the individual to the highesttraining or retraining the individual to the highest

possible level of functional ability.possible level of functional ability.

Continuous non ending activity.Continuous non ending activity.

Restoration of function in rehabilitativeRestoration of function in rehabilitativemedicine.medicine.

Involves physical medicine, OT, PT, speechInvolves physical medicine, OT, PT, speech

therapy, education and vocal guidance.therapy, education and vocal guidance.


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B.B. PreventionPrevention Prevention of diseases donePrevention of diseases done

byby

1.1. Promotion of healthPromotion of health

2.2. Early diagnosis and treatmentEarly diagnosis and treatment

3.3. Primary preventionPrimary prevention4.4. Secondary preventionSecondary prevention


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C.C. EducationEducation

Important function of the hospital.Important function of the hospital.

Provides training to the future professionalProvides training to the future professional

healthcare providers.healthcare providers.

It provides adequate facilities for teaching andIt provides adequate facilities for teaching and

research to address adverse health problems.research to address adverse health problems.

It imparts effective communication training.It imparts effective communication training.

Care of the patient is more scientific based.Care of the patient is more scientific based.


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D.D. ResearchResearch

Hospitals promotes research fornewHospitals promotes research fornew

knowledge generation.knowledge generation.

Teaching, research and patient care areTeaching, research and patient care are

interdependent.interdependent. Teaching hospitals are key components ofTeaching hospitals are key components of

health care system as they directly affect thehealth care system as they directly affect the

quality ofnew graduates and postgraduates.quality ofnew graduates and postgraduates.


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E.E. Health system supportHealth system support

Hospital support to other health careHospital support to other health care

services.services.

The relationship of hospital with other healthThe relationship of hospital with other health

care services varies.care services varies. Hospital has a central role of delivering allHospital has a central role of delivering all

types of health care facilities.types of health care facilities.


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F.F. EmploymentEmployment

Major employer.Major employer.

Labour intensive organization.Labour intensive organization.

3.2% of workforce employed in hospitals.3.2% of workforce employed in hospitals.

Policy makers emphasize more on this role.Policy makers emphasize more on this role.

Has huge impact on local socioeconomicHas huge impact on local socioeconomic

conditions.conditions.


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G.G. Social functionsSocial functions

a)a) State legitimacyState legitimacy

State bears the ultimate responsibility of providingState bears the ultimate responsibility of providing

good health care system.good health care system.

b)b) Political symbolPolitical symbol

Acts as a political symbol.Acts as a political symbol.

c)c) Provider of social careProvider of social care

Hospitals acts as a source of social as well asHospitals acts as a source of social as well as

health care.health care.

d)d) Civic prideCivic pride


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Hosp Functions

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