Pub Date : 2020-07-31DOI: 10.1017/9781108855440.012
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Pub Date : 2020-07-31DOI: 10.1017/9781108855440.001
M. Mckee, S. Merkur, N. Edwards, E. Nolte
Sometimes it seems that the hospital is the health system. Whether in popular culture, such as the American television series ER, in political and popular discourse, with its focus on opening and closing of hospitals, in statistical databases that give prominence to numbers of hospital beds, or in budgetary breakdowns, showing that the bulk of health service spending is concentrated in hospitals, it is clear that the hospital is seen as being at the heart of the health system (McKee & Healy, 2002). Even when the many other components of the health system are recognized, the hospital typically sits at the top of the pyramid. This is perhaps inevitable. Hospitals are highly visible. They are large buildings, well signposted, and adorned with the symbols of health care, such as red crosses. When politicians wish to make a statement on health services, they typically find a convenient hospital as a backdrop. Hospitals are also important for the public, not just when they are ill, but by providing reassurance that they will be cared for nearby if they become ill in the future. They play other roles too, as settings for the education of the next generation of health workers and through their contribution to the local economy. So even though they are only one part of the overall health system, they are an important part, and are recognized as such by almost everyone. Yet the concept of the hospital is a relatively recent one. Before the 18th century most people were cared for in their own homes, usually by family members or traditional healers. Institutionalized care, to the extent that it existed at all, was often in the hands of religious orders, providing somewhere that those with incurable illnesses could spend their last days in peace and tranquillity (Porter, 1999). What changed was the scientific revolution. Advances in a number of different areas brought new opportunities. In physics, the discovery of X-rays made it possible to look inside the human body as never before (Reed, 2011). Advances in optics paved the way for microscopes, and thus the
{"title":"Introduction – The changing nature of care provided in the hospital","authors":"M. Mckee, S. Merkur, N. Edwards, E. Nolte","doi":"10.1017/9781108855440.001","DOIUrl":"https://doi.org/10.1017/9781108855440.001","url":null,"abstract":"Sometimes it seems that the hospital is the health system. Whether in popular culture, such as the American television series ER, in political and popular discourse, with its focus on opening and closing of hospitals, in statistical databases that give prominence to numbers of hospital beds, or in budgetary breakdowns, showing that the bulk of health service spending is concentrated in hospitals, it is clear that the hospital is seen as being at the heart of the health system (McKee & Healy, 2002). Even when the many other components of the health system are recognized, the hospital typically sits at the top of the pyramid. This is perhaps inevitable. Hospitals are highly visible. They are large buildings, well signposted, and adorned with the symbols of health care, such as red crosses. When politicians wish to make a statement on health services, they typically find a convenient hospital as a backdrop. Hospitals are also important for the public, not just when they are ill, but by providing reassurance that they will be cared for nearby if they become ill in the future. They play other roles too, as settings for the education of the next generation of health workers and through their contribution to the local economy. So even though they are only one part of the overall health system, they are an important part, and are recognized as such by almost everyone. Yet the concept of the hospital is a relatively recent one. Before the 18th century most people were cared for in their own homes, usually by family members or traditional healers. Institutionalized care, to the extent that it existed at all, was often in the hands of religious orders, providing somewhere that those with incurable illnesses could spend their last days in peace and tranquillity (Porter, 1999). What changed was the scientific revolution. Advances in a number of different areas brought new opportunities. In physics, the discovery of X-rays made it possible to look inside the human body as never before (Reed, 2011). Advances in optics paved the way for microscopes, and thus the","PeriodicalId":112490,"journal":{"name":"The Changing Role of the Hospital in European Health Systems","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131238687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-31DOI: 10.1017/9781108855440.009
P. Cavanagh
Radiology is constantly evolving in its clinical application, playing a central role in numerous patient pathways in health care. Advances in sophisticated technologies have extended the scope of its application to every organ, offering not only essential services in diagnosis, monitoring treatment, and predicting outcomes but more recently therapy in the form of interventional radiology. The result of these developments is that the volume of activity is continuing to grow in all imaging techniques (often referred to as imaging modalities). The term “imaging” encompasses a number of diagnostic tests, some of which may be performed outside a radiology department. There is great variation among countries and by specialty in how these processes are undertaken and where. Imaging was originally founded on the plain X-ray. Despite the development of newer techniques towards the latter part of the 20th century, the plain X-ray still plays an important role in diagnosis (although its role is often to rule out pathology, rather than for primary diagnosis) and its uses continue to grow. However, the newer modalities of ultrasound, CT and MRI are increasing at a more rapid rate. Figure 9.1 shows the increased activity in England in the last 20 years. This demonstrates a 3.6% compound growth in the last five years. Major growth can be observed in the more complex cross-sectional imaging techniques, with compound annual growth rates (CAGR) in the last 10 years of 10% for CT and 12.3% for MRI (see Table 9.1). There is slightly less growth recorded in ultrasound at 5.3%, but this may be an underestimate as a significant amount of ultrasound is now performed outside imaging departments and would therefore not be recorded in these figures. Although these figures are specific for England, a similar picture is seen throughout Europe and internationally. This growth is significantly in excess of that expected by demographic drivers and is predominantly
{"title":"Advances in imaging","authors":"P. Cavanagh","doi":"10.1017/9781108855440.009","DOIUrl":"https://doi.org/10.1017/9781108855440.009","url":null,"abstract":"Radiology is constantly evolving in its clinical application, playing a central role in numerous patient pathways in health care. Advances in sophisticated technologies have extended the scope of its application to every organ, offering not only essential services in diagnosis, monitoring treatment, and predicting outcomes but more recently therapy in the form of interventional radiology. The result of these developments is that the volume of activity is continuing to grow in all imaging techniques (often referred to as imaging modalities). The term “imaging” encompasses a number of diagnostic tests, some of which may be performed outside a radiology department. There is great variation among countries and by specialty in how these processes are undertaken and where. Imaging was originally founded on the plain X-ray. Despite the development of newer techniques towards the latter part of the 20th century, the plain X-ray still plays an important role in diagnosis (although its role is often to rule out pathology, rather than for primary diagnosis) and its uses continue to grow. However, the newer modalities of ultrasound, CT and MRI are increasing at a more rapid rate. Figure 9.1 shows the increased activity in England in the last 20 years. This demonstrates a 3.6% compound growth in the last five years. Major growth can be observed in the more complex cross-sectional imaging techniques, with compound annual growth rates (CAGR) in the last 10 years of 10% for CT and 12.3% for MRI (see Table 9.1). There is slightly less growth recorded in ultrasound at 5.3%, but this may be an underestimate as a significant amount of ultrasound is now performed outside imaging departments and would therefore not be recorded in these figures. Although these figures are specific for England, a similar picture is seen throughout Europe and internationally. This growth is significantly in excess of that expected by demographic drivers and is predominantly","PeriodicalId":112490,"journal":{"name":"The Changing Role of the Hospital in European Health Systems","volume":"142 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133746592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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