Decline Of Hospitals

Role of Government in Growth and Decline of Hospitals in the United States The federal government plays several different roles in the American health care arena, including the provider of health care services, the purchaser of care, Quality regulator and sponsor of research, education and training programs for professionals. Each of these roles has both positive and negative effects on the system. This paper elaborates the role of government in growth as well as the decline of one of these arenas, Hospitals. Hospitals have transformed from primitive institutions of social welfare to consolidated systems of health services delivery. Evolution of Hospital system Between the early 1800 to 2000 United States

The basis for this was the growth in medical science and technology and the increase in the number of medical professionals. Governmental institutions, health care programs, drug regulations, and insurance also evolved during this period. After the advent of rapid urbanization in the late 1800s, hospitals were first built by the government called as voluntary hospitals started treating the poor and there came a need for more medical professionals and better training which led to the building of more Medical universities and hospitals. With the increase in the number of professionals there was a need for unified professional organizations and so American medical association (AMA) and American hospital association (AHA) were created in the late 1800s (Fillmore, 2009). By Mid-1900s U.S. government took initiatives to start institutions and programs, such as the National Institutes of Health (NIH) and the Centers for Disease Control (CDC), the initiation of social welfare programs like Medicare and Medicaid, which supported and boosted the growth of hospitals. Factors affecting the growth of hospitals: Haglund and Dowling (1993) identified six significant factors that would be responsible for the growth of hospitals.

1. Advances in Medical science

2. Development of specialized

Between 1965 and 1980 number of community hospitals increased from 5,736 (741,000 beds) to 5,830 (988,000 beds) and the admission rate has increased from 130 to154 (AHA, 1990). Role of Government in the Decline of Hospitals There has been a tremendous shift and downfall in the hospital growth since the mid-1980s to almost 2005 and this shift is because of decreased utilization of inpatient services and increased use of outpatient services. The three main forces responsible for this shift are the changes in hospital reimbursement, the impact of managed care, hospital closures (Shi. L and Singh. D, chapter 8, 2015). Of these three factors government’s role in changes in reimbursements caused the major decline.

The role of Changes in