Origins and History of Acute Hospitals A number of European hospitals can trace their roots back to the twelfth century. These were typically founded by religious orders, and usually formed part of an almshouse for the poor and infirm. By the late eighteenth century, similar institutions were becoming more common in larger towns and cities as the process of urbanization and industrialization began to gather pace in Europe andNorth America. However, these hospitals were still seen as places of death, disease, and destitution from which few emerged alive, and were shunned by the wealthy (who were treated at home by their physicians and surgeons).This bleak picturewas transformed during the nineteenth century as the concepts of hygiene and antisepsis and the beginnings of modern anesthesia delivered startling improvements in patient survival, so that hospitals began to be seen as a place of safety and healing, rather than a place for the indigent to die. This transformation was complete by themiddle of the twentieth century, as effective antimicrobials greatly reduced the risks of infection, and advances in therapeutic technology steadily improved the clinical outcomes that patients could expect to receive from hospital treatment. Indeed, by the end of the twentieth century, calls for a reduced reliance on hospital care and a concern that acute hospitals may overmedicalize the natural processes of birth, aging, and dying, had become commonplace in many countries.
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