Hospitals

Definitions

Hospitals are increasingly defined by the various organizations that license, regulate, and accredit them. As such, the technical definition of a hospital may vary widely across nations, states, and programs.

The World Health Organization (WHO), for example, broadly defines a hospital as an organization that is permanently staffed by at least one physician, can offer inpatient accommodations, and can provide active medical and nursing care.

The American Hospital Association (AHA) more narrowly defines a hospital as an organization that (a) has at least six inpatient beds that are continuously available for care; (b) is constructed to ensure patient safety; (c) has an identifiable governing authority responsible for running it, a chief executive who reports to the authority, a medical staff with licensed physicians, and at least one registered nurse supervisor and continuous nursing services; (d) admits patients only by a member of the organization's medical staff; (e) maintains medical records; and (f) provides pharmacy services and patient food services, including special diets.

The National Center for Health Statistics (NCHS) defines a hospital, for the purpose of its surveys, as an organization with an average length of inpatient stay of less than 30 days (short stay) whose specialty is general (medical or surgical) services or that provides general medical care for children. NCHS excludes federal hospitals, hospital units of institutions, and hospitals with fewer than six beds staffed for patient use.

Classifications

Hospitals are classified in many ways, such as by their ownership, the services they provide, whether they are community hospitals, and whether they are members of a multihospital healthcare system.

In terms of ownership, hospitals are classified as being nongovernment not-for-profit institutions (i.e., church operated, or other), investor-owned (for profit) institutions, or government-owned institutions (i.e., federal, state, or local).

In terms of the services they provide, hospitals are classified as being general institutions (providing a wide array of patient services, diagnostic and therapeutic, for a variety of medical conditions), special institutions (providing services for patients with specific medical conditions), rehabilitation and chronic-disease institutions (providing services to handicapped or disabled individuals requiring restorative treatment), or psychiatric institutions (providing services for patients with psychiatric illnesses).

A very important distinction is whether an institution is a community hospital or not. The AHA defines community hospitals as all nonfederal, short-term (having an average length of inpatient stay of less than 30 days), general and other special hospitals (e.g., children's hospitals, obstetrics and [Page 619]gynecology, rehabilitation hospitals) whose facilities and services are available to the public.

Hospitals can also be classified by whether they are members of a multihospital healthcare system (two or more hospitals owned, leased, sponsored, or contract managed by a central organization) or a single stand-alone institution.

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