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Health Care

Historical Analysis Of Healthcare On Human Service


The history of human care dates back to ancient times when people used self-treatment by herbs to heal wounds and treat diseases. However, the developed methods of human care started in the mid-19th century when Florence Nightingale redefined the concept of nursing care and provided scientific definitions and ways to provide necessary nursing care. the surgical practice initially was meant to cure amputations, lacerations, and draining of rotten wounds. This paper will describe the history of the skilled nursing facility and inpatient surgery and provide its modern methods in practice right now.

Skilled Nursing Facility


The skilled nursing practice is aimed to achieve the following outcomes:

  1. Provision of evidence-based nursing care and comfortable and familiar conditions in hospitals or other healthcare facilities
  2. Provision of holistic care i.e. complete care for the physical, psychological, social, and spiritual self of the person, while ensuring that patient gets complete prevention and cure of disease.
  3. To perform methods of collective care, which involves team effort of nurses while considering standards of care.
  4. Effective record and measurement of care.
  5. Effective methods of delegation and palliative care.

Ownership and governance

The healthcare facilities and nursing service providers are governed by hospitals and healthcare associations

Regulatory bodies

The following agencies are the regulatory bodies of the skilled nursing facility in various countries:

  • International Council Of Nurses (ICN)
  • American Nurses Association (America)
  • Canadian Nurses Association (Canada)
  • Australian Nurses and Midwives Association (Australia)
  • British Nurses Association (United Kingdom)

Reimbursement schemes

The reimbursement process in the skilled nursing facility is done by the hospital

  • The reimbursement scheme is valid if the person stays in the hospital for three or more days.
  • The amount is calculated by the number of days and the type of service provided to the patient.
  • The patient’s resource utilization is measured that calculating the daily amount of service, which includes five levels of rehabilitation depending on the service hours.
  • The patient at the end of his discharge is asked to clear his reimbursement amount from the hospital authorities before his discharge.

Finance mechanism

Before the application of the Medicare Act in 1965, nurses were funded by the variable standards of their pay scale. There were no criteria on how a nurse will be paid and no standards of nurse pay calculation. After the Medicare Act, the nurses are provided their pay by the specified payroll of nurses depending on the type of Medicare, which can be the hospital or hospice, outpatient service, self-administered prescription, and alternative experimentation if none of the other three are applicable.

Economic and social forces

The skilled nursing facility was funded by various social groups when proper benefactors of the field were not defined. After the application of the Medicare act, the future benefactors of nursing facilities were defined by PPACA which is responsible for funding of the nursing facilities

Inpatient Surgery

Inpatient care is defined as the care provided to patients who undergo surgery at the hospital and stay at the hospital for one night or more.


  1. Effective surgery of patients
  2. Collaboration with physicians in performing surgery and post-surgery operations
  3. Provision of complete nursing care to the inpatients.
  4. Care of patients till they are discharged from the hospital

Ownership and governance

The inpatient surgery healthcare service was monitored by the healthcare providers in the past and after the advancement of medical healthcare, this ownership is given to solely the hospital.

Regulatory bodies

The inpatient surgery service is regulated by the Ambulatory Surgery Center Association (ASCA) which governs the rules and regulations applied to surgeons and other inpatient care staff.

Reimbursement schemes

The reimbursement in surgical practice is done by a single payment that includes the amount. The total amount of service is calculated by the type and amount of surgical services provided and the Medicare Payment Advisory Commission (MedPAC) is consulted to calculate the payment for surgical services.

Finance mechanism

Inpatient surgery financing is different in government and private hospitals. The private hospitals are mostly funded by social workers and philanthropy programs in which they collect funds from the people to run the operations of hospital operations. The government hospitals’ surgical department is financed by the government and they provide free care or ask for very little charges for inpatient surgical care.

Economic and social forces

Inpatient surgery is funded by social services that fight for a cause in most hospitals. Various trusts provide finance for specific types of surgeries like breast cancer surgery trusts. These trusts fund both government and private hospitals for surgeries that are common. However, not all inpatient surgeries are funded by social services and patients have to pay the cost before admittance to the hospital.


The skilled nursing practice and inpatient surgery have developed its methods as the field of medical science improved and research was done in this field. Both skilled nursing practice and inpatient nursing has improved after the application of the Medicare act. This Medicare act has also defined the finance methods and pay scale of nurses and other healthcare providers and defined the reimbursement schemes for the payments. However, there is a need for more research in refining the nursing practice to ensure better health facilities for patients.


Driessen, J., Castle, N. G., & Handler, S. M. (2018). Perceived benefits, barriers, and drivers of telemedicine from the Perspective of Skilled Nursing Facility Administrative Staff Stakeholders. Journal of Applied Gerontology, 37(1), 110-120.

Egenes, K. J. (2017). History of nursing. Issues and trends in nursing: Essential knowledge for today and tomorrow, 1-26.

Grenda, T. R., Krell, R. W., & Dimick, J. B. (2016). Reliability of hospital cost profiles in inpatient surgery. Surgery, 159(2), 375-380.

Keohane, L. M., Grebla, R. C., Mor, V., & Trivedi, A. N. (2015). Medicare Advantage members’ expected out-of-pocket spending for inpatient and skilled nursing facility services. Health Affairs, 34(6), 1019-1027.

Spaner, S. J., & Warnock, G. L. (1997). A brief history of endoscopy, laparoscopy, and laparoscopic surgery. Journal of Laparoendoscopic & Advanced Surgical Techniques, 7(6).



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