Hospital Administration: An International Survey
| DOI | 10.1177/002085236302900203 |
| Author | T.E. Chester |
| Published date | 01 June 1963 |
| Date | 01 June 1963 |
| Subject Matter | Articles |
Hospital
Administration:
An
International
Survey
by
Professor
T.
E.
CHESTER,
Department
of
Social
Administration,
University
of
Manchester.
UDC
362.111
In
recent
years
there
has
been
a
very
great
increase
in
the
attention
paid
to
hospital
administration,
which
is
emerging
as
a
separate
field
of
administration
and
as a
special
discipline
for
teaching
and
research
in
many
establishments
of
higher
education.
For
example,
the
University
of
Manchester
established
in
1955
a
new
chair
in
Social
Administration,
whereas
before
the
problems
in
this
field
came
under
the
purview
of
the
Professor
in
Government
and
Public
Admin-
istration.
Within
the
new
Department
of
Social
Administration,
hospital
administra-
tion
quickly
became
an
important
field
of
study
and
teaching,
including
a
special
post-
graduate
course
leading
to
a
diploma
which
was
initiated
in
co-operation
with
the
British
Ministry
of
Health
and
their
efforts
to
train
the
senior
hospital
administrators
of
the
future
for
the
National
Health
Service.
It
is
the
purpose
of
this
article
to
explore
briefly
the
causes
contributing
to
the
emer-
gence
of
hospital
administration
as
a
special-
ised
field,
to
sketch
briefly
the
changing
role
of
hospitals
in
the
modern
world,
and
to
outline
patterns
of
organisation
as
they
are
developing
in
various
countries.
This
will
be
followed
by
an
analysis
of
some
of
the
major
problems
facing
hospital
administrators
in
the
1960’s,
and
a
glimpse
into
significant
trends
for
the
future.
1.
Emergence
of
hospital
administration
as a
separate
field
of
adrninistration :
The
reason
for
the
attention
paid
to
hospital
administration
in
nearly
all
countries
during
the
last
decade
can
be
ascribed
broadly
to
three
main
reasons.
Firstly,
the
growing
complexity
of
hospitals
as
an
object
of
administration;
secondly,
the
steeply
rising
costs
of
building
and
running
them;
and
thirdly,
the
vast
demand
for
hospital
services
in
most
civilised
countries.
Under
the
first
heading
one
has
to
realise
that
a
modern
hospital
is
probably
one
of
the
most
complex
administrative
organisations
in
the
world.
In
it
there
will
be
working
an
array
of
pro-
fessions,
ranging
from
high-grade
medical
consultants
to
humble
cleaners
and
porters.
It
t
will
have
to
provide
complete
r
hotel
facilities
»
in
themselves,
today
a
difficult
administrative
task
on
which
there
are
super-
imposed
vital
medical
facilities
including
apparatus
only
just
coming
off
the
drawing
board
of
modern
electronic
science.
The
task
of
co-ordination
of
these
different
grades
of
staff,
the
attempt
to
plan
the
smooth
running
of
the
different
departments,
has
indeed
become
a
tremendous
task
challenging
the
highest
quality
in
an
administrator.
To
this
has
to
be
added,
as
already
indicated,
the
increase
in
costs
and
the
demands
made
by
hospitals
on
the
resources
provided
by
the
national
economy.
To
give
just
a
few
exam-
ples.
The
average
costs
of
treating
a
patient
per
day
in
an
English
hospital
varied
last
year
between
f5lC7
and
the
cost
per
case
treated
during
the
same
period
averaged
from
,~60
to
nearly
£100.
Equally,
the
building
of
new
hospitals
is
not
only
straining
the
resources
of
architects
but
ranges
-
taking
into
account
a
fully
equipped
modern
hos-
pital
-
around
~10,000
per
bed
as
the
costing
unit.
In
Great
Britain,
for
example,
the
total
cost
of
the
National
Health
Service
amounted
in
1962/1963
to
approximately
,~ 1,000
million,
of
which
60%,
i.e.
,~600
million,
was
devoted
to
the
hospital
service
alone.
The
modern
hospital,
with
its
internal
spe-
cialisation
and
complexity,
with
its
increasing
costs,
has
however
to
face
-
and
this
is
pro-
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