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    Development of U.S. healthcare facilities

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    Describe the development of U.S. healthcare facilities in the 20th and early 21st centuries. What have been the major developments and primary drivers of change in U.S. healthcare facilities over the past one hundred years?

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    Briefly, the driver has been money. Hospitals have grown from community, county, or charity hospitals to hospital systems. That's how most hospitals in the first 75 years of the 20th century saw themselves. For example, my grandfather ended up in Cook County Hospital in Chicago for a month once back in the 1950's. There was no bill since he was a county resident. The medical work was performed by physicians (who were also teachers in associated medical schools), residents, medical students, nurses, and nursing students. The need then was to provide the very best care available at the lowest cost which means that ancillary testing (labs, radiology, etc.) was discouraged.

    When President Reagan started the DRG system of payments in the 1980's, the whole ballgame changed. Now hospitals could make more money by encouraging ...

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    The following posting discusses the development of U.S. healthcare facilities in the 20th and 21st centures.