B.S.S.

(Honours) in Health Economics

HE 306: Hospital Management (HM)
Hospitals

Dr. Aninda Nishat Moitry

MBBS, MPH, MSc, FRSPH
20 March 2023
 Overview of the presentation

• Definition of hospital
• Types of hospital
• Functions of hospital
• Departments of hospital
• Hospital: multidimensional identity
• Peculiarities of hospital as an
organization
• Hospital organization
 Hospital terminology

• The word "hospital" comes from the Latin

hospes, signifying a stranger or foreigner, hence
a guest
• Another noun derived from this, hospitium came
to signify hospitality, that is the relation between
guest and shelterer, hospitality, friendliness, and
hospitable reception
• Hospes is thus the root for the English words
host, hospitality, hospice, hospital, hostel, and
hotel
 Hospital

• Not only for human being, but also others –

animal hospital, bird hospital, plant hospital etc.
• A repair shop for specific portable objects – doll
hospital, violin hospital, clock hospital etc.
• A charitable institution for the needy, aged,
infirm, or young
• An institution where the sick or injured are given
medical, surgical or psychiatric care
• A place where people who are very ill or injured
are treated by doctors and nurse
 Definition of Hospital by WHO

An integral part of the medical and social

organization which is to provide for the
population complete heath care, both curative
and preventive; and whose out-patient services
reach out into the family in its home
environment; the hospital is also a centre for
the training of health workers and for bio-social
research
 Types of Hospitals

• According to type of services provided

• According to ownership
• According to level of care
 Types of Hospitals (Contd.)
According to types of services provided:
1. Clinics:
• Medical facility smaller than a hospital
• Generally provide only outpatient services

2. General hospitals:
• Deal with many kinds of disease and injury, and normally
have an emergency department to deal with immediate
and urgent threats to health

3. Specialized hospitals:
• Deal with specific medical needs such as psychiatric
problems, certain disease categories such as cardiac,
oncology, or orthopedic problems, and so forth
 Types of Hospitals (Contd.)
According to ownership:
1. Public hospitals:
• Owned, administered and controlled by the government
or autonomous body
• Provide free care for patients
• May offer private accommodation for fee paying patients
2. Private or non-governmental hospitals:
• Proprietary: privately owned or controlled by an
individual or group of Physicians or citizens or by private
organization (profit making)
• Voluntary: owned and operated by non-profit
organizations, i.e. mosque or church authorities
 Types of Hospitals (Contd.)
According to level of care:
1. Primary:
✔ Union health family welfare centers (UHFWC)
✔ Upazila health complexes (UHC)
2. Secondary:
✔ District hospitals
✔ Maternal and child welfare centers
3. Tertiary:
✔ Medical college hospitals (teaching)
✔ Specialized hospitals: BSMMU has over 1200 beds
providing general and specialist hospital services
through 14 departments
 Functions of hospital

• Curative care
• Preventive and promotive care
• Domiciliary care
• Training
• Research
• Health education
• Accident and emergency services
• Disaster management
• Laboratory services
• Record keeping
 Departments of Hospital

• Professional health services departments

• Non –professional health services

departments
 Departments of Hospital (Contd.)

Professional health services department:

1. Medical department: provides various clinical
services
2. Nursing department: consists of nursing
service and nursing education
3. Paramedical department: includes laboratory,
pharmacy, physical medicine and rehabilitation,
radiology and dietary departments
 Departments of Hospital (Contd.)

Professional health services department:

4. Outpatient department: a miniature of the
hospital except that the patients are ambulatory
5. Accident and emergency department:
life-saving services immediately needed after
thorough examination by the responsible
physician
6. Operating theatre: equipped for the
performance of surgical procedures
 Departments of Hospital (Contd.)

Non-professional health services department:

• Admission
• Personnel (HR)
• Purchasing
• Medical records
• Housekeeping (domestic services)
 Departments of Hospital (Contd.)

Non-professional health services department:

• Laundry
• Mechanical
• Maintenance
• Central sterile supply
 Hospital: Multidimensional identity

• The hospital also acts as referral center and a center for

training of health workers and for biosocial research
• It is highly labor-intensive organization with personnel
from different backgrounds and education
• Hospital is a highly complex, economic and scientific
organization
• Hospital in other words is an agency of delivering health
care service to the community
 Hospital: Multidimensional identity
(Contd.)
• In present day, hospital is a very complex organization
and its complexity of functions has been steadily
increasing due to growth of various specialties and
super-specialties
• In the modern sense, the word ‘hospital’ is an health care
institution which provide patient’s accommodation for
various time period
• In the history it was “a place of hospitality”, for example,
the Chelsea Royal Hospital, established in 1681 to
house veteran soldiers
• During the middle ages, hospitals served different
functions such as being almshouses for the poor or
hostels for pilgrims
 Hospital: Multidimensional identity
(Contd.)
Hospital is a combination of many processes-
▪ To the community, it is a place to receive medical care
▪ To the physician, it is a place to treat patients
▪ To the employees, it is a place to work
▪ To the hospital manager, it is a multifaceted
organization
 Peculiarities of a hospital as an
organization
• Hospital is a social institution it has to interact with a
wide spectrum of population having different cultural and
socio-economic background
• Hospital is a place, where the scientific and technological
innovation of medical sciences are put into operation and
practiced for the healthful living of the community
• The product of the hospital is ‘service’ which cannot be
easily quantified and also the quality assessment is not
so easy
• The service in the hospital is always personalized not
generalized
 Peculiarities of a hospital as an
organization (Contd.)
• Professional care are directly rendered by the medical,
nursing and other personnel according to the need of
each case or client
• In many cases, the hospital service can not be
mechanized, standardized or pre-planned to meet the
specific need
• The hospital service is a team work rather than an
individual service
• The hospital service is normally emergent in nature and
two similar situation need same treatment
 Peculiarities of a hospital as an
organization (Contd.)
• The wide spectrum of staffs involved in the hospital
activity ranges from the highly skilled professional to man
who may not have visited a school
• Therefore, the management of this varied group of
people need balanced psycho-social approach on the
part of the manager
• The dual control of professional authority and the
executive authority in the hospital, invariably leads the
management situation
• The hospital is being treated as industry for profit with
the view to achieve maximum output against minimum
input by applying management tools and techniques
 Hospital organization
Clinical and nursing Supportive services General Utility services
services administrative
services (including
business)
• In-patient • Clinical • Personnel • Dietary
services laboratory management • Laundry and
• Out-patient • Radiology and • Financial linen
services imaging management • Housekeeping
• Emergency and • Nuclear medicine • Material • Engineering
casualty services • Blood bank management services
• Operation theatre • Store and • Marketing • Security and fire
• Nursing services pharmacy services
• Central sterile • Hospital waste
supply services management
• Medical records • Transport
• Medical audit • Communications
• Physical • Public relations
medicine and
rehabilitation
• Medical social
services
 Patient centered activities of hospital

Out-patient services In-patient services

Nursing services OT services

THE PATIENT
Emergency services Utility services

Support services Business services

Administrator of
hospital functions
Preventive and Curative and Education and
promotive care rehabilitative care research
Management functions:
i.e. Planning, Organizing, Directing or leading, Controlling
Thank you