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Evolution of the Hospital Industry: A Comparative Analysis

In this comparative analysis report, the evolutions and changes of the hospitals during the time periods of the 1800s, 1960s, and today will be reviewed to dive deeper into the progression of the healthcare sector throughout the years. This comparative analysis will evaluate the evolution and progression through the changes such as costs, settings, and treatment procedures that occurred greatly in the hospitals over the period of time from the 1800s onwards.

Hospital Care Evolution

In the 1800s, hospitals were not mainly care facilities but the almshouses for needy and poor, where people with contagious illnesses and bad mental conditions were treated. Medical services that were provided to patients were not safe, nor did the surgeries. Later in the 1850s, the hospital system was fully developed and owned by physicians in the healthcare systems. Further developments were made in the 1960s when the Joint Commission on Accreditation of Hospitals (JCAH) was established. It provided published standards and accreditation for the hospitals. Thus, in the 1960s, hospitals were corporations that extended massive employment opportunities for hundreds of people, and care delivery was much better for certain medical conditions. The hospitals also provided inpatient and outpatient services to the patients (Sheingold & Hahn, 2014). However, today, hospitals are equipped with more advanced technologies for disease management and treatments for any medical condition. They have comprehensive coverage of medical decisions based on evidence-based healthcare for unhealthy populations.

Hospital Environment

In the 1800s, hospital environments primarily serviced needy individuals who had contagious and deplorable health conditions. Patients had no luxury of individual rooms for their treatments. Rather every hospital environment offered a great hall where all patients received collective treatment. By that time, hospitals were considered places of death where people were afraid to go because of the unregulated care systems where “care” was non-existent (Moseley III, 2008). By the 1960s, hospitals were seen as massive enterprises where a lot of employment opportunities were offered, and people received care in individualized disease containment areas. Beds were available along with other facilities such as x-rays, meals, and laboratory services in the structured patient care accommodations to allow better workflow and reduce the spread of diseases or deaths (Schwartz et al., 2018). In today’s world of emerging technology, hospitals are enterprises that not only offer numerous opportunities for people who build their careers in the medical field but are also places where patients are provided with outpatient and inpatient services through surgeries, treatments, and therapies for better patient care outcomes.

Staff Education

In the 1800s, medical education was non-existent. The public was not ready to accept the changes and better treatment options, so education was very minimal in that era. However, the progression in the healthcare sector started with the emergence of nursing education in the 1960s. People who were passionate about extending their helping hands to the unhealthy population of society were provided with medical education. Medical professionals and nurses understood disease containment and appropriate procedures of treatments when nursing education was implemented in the care industry (Schwartz et al., 2018). In today’s care system, medical professionals, whether they are doctors, nurses, or volunteers, all are provided with the necessary education in their respective fields. After the 2000s, it became mandatory for every medical professional to complete extensive education and training courses in order to serve in any hospital facility (Marjoua & Bozic, 2012).

Level of Care

The level of care patients were provided during the 1800s was so minimal because of no facilities. People used to trust local healers more than professional doctors. No understanding of proper treatment and disease containment was known which eventually led to the spread of diseases in many areas. However, in the 1960s, medical care evolved greatly due to the establishment of the Joint Commission on Accreditation of Hospitals (JCAH). Presently, care systems are fully equipped with every facility that is needed to limit the spread of diseases and every medication or vaccine to cure diseases.

Paying for Your Care

In the 1800s, hospitals were mainly free of charge because wealthy people funded the facilities. During that time, extensive care was only provided to wealthy patients or families at their homes as doctors were so expensive. Care systems progressed in the 1960s which led to the establishment of Medicare and Medicaid to make health services affordable for patients. Today, people who do not have health insurance coverage cannot afford expensive treatments as healthcare costs have become expensive since the incorporation of technology in the care system in the 2000s (Marjoua & Bozic, 2012).

Comparative Analysis

Hospital systems in the 1800s were not as advanced as the care systems were in the 1960s and today. People usually had faith in local healers and the care services were provided to patients at almshouses in deplorable conditions. Wealthy people had the luxury to call a doctor at home as they could bear the expenses of doctors and medications otherwise, commoners were deprived of that necessity. Hospitals were seen as places where people would go to die, so people self-medicated themselves without any proper medical interventions. The healthcare system witnessed an evolution in the 1960s with the establishment of the Joint Commission on Accreditation of Hospitals (JCAH), as well as the inclusion of educational courses and medical training. Patients sought medical care at hospitals that were relatively small as compared to the care systems of today, where the cost of treatment was also low. Today, hospital care, as compared to the 1800s and 1960s, is so advanced and well-structured that it accommodates a large number of unhealthy people by providing inpatient as well as outpatient services. Today’s hospitals are being built to provide patients with better healthcare services as they are being provided with the amenities of home.


Hospital care has evolved greatly from the 1800s to today as the place that was seen as a place for death is now seen as a place where people receive adequate care. With time, education, adequate training, technological advancements, and alignment with insurance companies, the healthcare sector has improved for the better. Although the cost of healthcare has increased with the passage of time, every single dollar is worth spending because of the safe treatments and advancements in the care systems.


Marjoua, Y., & Bozic, K. J. (2012). Brief history of quality movement in US healthcare. Current Reviews in Musculoskeletal Medicine, 5(4), 265–273.

Moseley III, G. B. (2008). The US health care non-system, 1908-2008. AMA Journal of Ethics, 10(5), 324–331.

Schwartz, C. C., Ajjarapu, A. S., Stamy, C. D., & Schwinn, D. A. (2018). Comprehensive history of 3-year and accelerated US medical school programs: A century in review. Medical Education Online, 23(1), 1530557.

Sheingold, B. H., & Hahn, J. A. (2014). The history of healthcare quality: The first 100 years 1860–1960. International Journal of Africa Nursing Sciences, 1, 18–22.


Subject/Topic 1800s 1960s 2000s
Hospital Environment

(Describe the overall hospital environment.)


  • Not used
  • A place of death
  • Unregulated care environment
  • Care was provided at almshouses
  • Care was provided to all patients in a great hall collectively.
  • Containment of diseases
  • Treatments
  • Small hospitals
  • Care services were provided in individualized rooms
  • Big hospitals
  • Structured designs
  • Better airflow and workflow
Medical Staff Education Level

(Describe the care providers and their education levels.)


  • No medical education
  • No training
  • Establishment of JCAH
  • Medical professionals were provided with formal training
  • Nursing education started
  • Strict education and training courses
  • Extensive medical courses to practice medicine
Level of Care

(Describe the quality of care for each century and if it improved.)


  • Local healers used home remedies.
  • Doctors provided care at the homes of wealthy people as the cost of healthcare was so expensive.
  • Poor did self-care
  • Care and treatments were provided for serious illnesses
  • Inpatient services
  • Outpatient services
  • Therapies
  • Surgeries
  • Treatments
  • Vaccinations
Paying for Care

(Describe how care was paid for.)

  • Expensive treatments
  • Free-of-charge for poor
  • Wealthy people funded the cost for the needy segment of society
  • Health insurance, including Medicaid and Medicare, was introduced
  • Expensive healthcare
  • Out-of-pocket care costs by patients
  • Medicaid and Medicare insurance programs cover healthcare cost



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