The document provides an in-depth overview of hospitals as complex organizations dedicated to health care, outlining their definitions, classifications, and organizational structures. Hospitals are categorized based on various criteria such as clinical basis, ownership, objectives, size, management, cost, and level of care, highlighting their critical roles and the services they offer. Moreover, it details the roles of medical and administrative staff, associated medical services, and supportive paramedical services crucial for effective healthcare delivery.

1. Mr. Mangesh Bansod
ASST. PROF.
SDDVCPRC, Panvel
Hospital and it’s
organization

2. Definition of Hospital
 Hospital is a complex organisation .
 It is an institute of providing health to individuals with the
help of complex and special scientific equipments in the
presence of trained staff who are well-educated in the
problems of modern medical science.
 For achieving the goal of maintaining a good health of
individuals suffering from diseases and relieving them from
pain, all the staff members of hospitals coordinate together.
 In modern hospitals, there is ample of space and well -
qualified and skilled personnel who provide curative,
restorative, and preventive services of extreme quality to all
the patients irrespective of their race, colour, creed, or
financial status.
 As per WHO, “Hospitals are reservoirs of critical resources
and knowledge. They can be classified according to the
interventions they provide, the roles they play in the health
system and the health and educational services they offer
to the communities in and around them.”

3. Classification of Hospital

4. Classification Based on Clinical Basis-
Hospitals are classified as follows based on their anatomical- physiological
specialisation:
•ENT (Ear, Nose and Throat) hospitals,
•Eye hospitals,
•Orhopaedic hospitals, and Kidney hospitals.
Hospitals are classified as follows based on the client group they serve:
•Paediatric hospitals for children,
•Gynaecological hospitals for women, and
•Maternity hospitals for mothers.
Hospitals are classified as follow based on the system of medicine adopted
for treatment:
•Allopathic hospitals,
•Ayurvedic hospitals,
•Homeopathic hospitals,
•Unani hospitals, and
•Hospitals of other systems of medicine.
Classification Based on Length of Stay of Patient- on this
basis of short term and long term, the hospitals are categorised
into acute care hospitals and chronic care hospitals
Classification of Hospital

5. Classification Based on Non-Clinical Basis
 Classification Based on Ownership/Control Basis:
 Public Hospitals: These hospitals are under the control of
Central or State Governments or local bodies on non-
commercial lines. They can be general hospitals or specialised
hospitals or both.
 Voluntary Hospitals: These hospitals are recognised and
combined under the Societies Registration Act 1860 or
Public Trust Act 1882 or any other act of Central or State
Governments. They are supported by the public or private
funds on a non-commercial basis.
 Private Nursing Homes: These are regulated by an
individual doctor or a group of doctors on a commercial
basis. Patients suffering from infirmity, advanced age, illness,
injury, chronic disease, disability, etc. are admitted here.
However, patients having communicable diseases, alcoholism,
drug addiction, or mental illness are not treated.
 Corporate Hospitals: These hospitals are public limited
companies running on commercial lines and formed

6. Classification Based on the
Objectives
 Teaching-cum-Research Hospitals: These are the hospitals having a
college for education of medical, nursing, dental, or pharmacy.
Teaching is the major aim of these hospitals and the provision of
healthcare is secondary. AIIMS (New Delhi), PGIMER (Chandigarh),
JIPMER, (Pondicherry), KR Hospital (Mysore), Victoria Hospital
(Bangalore), etc.
 General Hospitals: These hospitals help for curing the common
diseases. They have at least two or more doctors, who can offer in -
patient accommodation and provide medical and nursing care for more
than one category of medical discipline, such as general medicine,
general surgery, obstetrics, gynaecology, paediatrics, etc. Their primary
aim is to provide medical support to the people, and teaching and
research are secondary. Examples of these hospitals are all
districts and Taluk or PHC or rural hospitals.
 Specialised Hospitals: These hospitals provide medical and nursing
care for one discipline or a disease or a condition of one system. They
concentrate on a particular aspect or body organ and give medical and
nursing care in the particular field, e.g., tuberculosis, ENT,
ophthalmology, leprosy, orthopaedics, paediatrics, cardiology, mental
health/psychiatric, oncology, STDs, maternal, etc.
 Isolation Hospitals:These hospitals treat patients who are suffering
from infections and communicable diseases and need to be isolated.
Epidemic diseases hospital (Bangalore) is an example of isolation

7. Classification Based on Size (Bed Strength)
 Teaching Hospitals: These hospitals have 500
beds and can be increased depending on the number of
students.
 District Hospitals: These hospitals have 200 beds and
can be increased up to 300 depending on the
population.
 Taluk Hospitals: These hospitals have 50 beds and can
be increased depending on the population.
 Primary Health Centres: These hospitals have 6 beds
and can be increased up to 10 depending on the needs.

8. Classification Based on Management
 Union Government/Government of India: These hospitals are
controlled by the Government of India. Hospitals run by the railways,
military/defence, mining or public sector activities of Central
Government
 State Governments: These hospitals are controlled by the state or
union territory. Government authorities and public sector activities
running through the state or union territories comprising the police,
prison, irrigation department, etc.
 Local Bodies: These hospitals are managed by the local bodies,
such as municipal corporation, municipality, Zila Parishad, Panchayat,
 Autonomous Bodies: These hospitals are formed under a special
act of parliament or state legislation. They are financially supported by
the Central/State Government/Union territory. AIIMS (New Delhi),
PGIMER (Chandigarh), NIMHANS (Bangalore), KMIO (Bangalore),
etc
 Private: These hospitals are run by an individual or by private
organisation. MAHE (Manipal), Manipal Hospital (Bangalore), Hinduja
Hospital (Mumbai), etc.

9. Classification Based on Cost
 Elite Hospitals: These hospitals are a symbol
of high -tech medical development. The per day room
rates vary between 300-1200. The deluxe rooms have
fridge, television, and telephone. Excluding the medical
care, they are similar to five -star hotels, thus, are also
called five-star hospitals .
 These institutions reserve a particular percentage of their
capacity for poorer sections and also support a particular
percentage of their accommodation cost. For example,
Jaslok has reserved 25% for the poorer sections and 30%
at half the rates. In Mumbai hospital, 315 beds out of 680
are free and 112 beds are funded.
 Budget Hospitals: These hospitals are for moderate
budget and low budget users, e.g., civil hospitals,
corporation hospitals, etc.

10. Classification Based on the Level of Care
 Primary Hospitals: These hospitals denote the first level of contact between the individuals
(including their families) and the health system. According to Alma Ata Declaration of 1978,
primary health care indicates serving the community it served; including mother and child care,
which comprised of family planning, immunisation, prevention of locally endemic diseases,
treatment of common diseases or injuries, delivery of essential facilities, health education, pro
vision of food and nutrition, and adequate supply of safe drinking water.
 Primary healthcare in India involves a network of sub-centres and primary health
centres in rural and urban areas, which are provided through health posts and family
welfare centre s. A sub -centre has one auxiliary nurse midwife and multipurpose health
worker .
 Secondary Hospitals: These hospitals are provided by such medical specialists, who do
not have direct contact with the patients, like urologists, dermatologists, cardiologists, etc.
According to National Health System Policy , a patient proceeds further for secondary
care after being referred by a primary care professional. A patient cannot directly move to
secondary care as sometimes health systems impose a restriction of referral on a patient in
terms of payment; however, this varies from countries to countries. The following
two systems come under this category:
 District Health System: This system provides child health and maternity care. It serves
around 25,000 -50,000 users and includes various healthcare centres and district hospitals.
These healthcare centres receive referrals from various primary health cares and remain
open for 24×7. District hospitals include emergency services, neonatal care,
comprehensive emergency obstetrics, etc.
 County Health System: This system includes hospitals that receive referrals from
district and community health systems. County hospitals provide gynaecologic services,
general medicine, obstetrics, general surgery, etc. and remain open for 24×7.
 Tertiary Hospitals: These hospitals are a third level of health system. They provide a
specialised consultative care to a patient referred from primary and secondary medical
care. Specialised intensive care units,advanced diagnostic support services, and

11. Organization Structure of a Hospital
 The organisation of modern day hospitals is a complex
network of committees, departments, personnel, and
services. The hospitals are not only caring, people-
oriented institutions, but also many -faceted, high -tech
business.
 They operate like other large businesses constantly
concerned about their bottom line, and have a hierarchy
of personnel and channels of authority. However, the
number of administrative personnel depends on the
hospital size.
 The organisation of hospitals includes the following:
 Administrative staff,
 Medical staff,
 Associated medical services, and
 Supportive paramedical services and staff.

13. Administrative Staff
 The administrative services of a hospital are controlled by a
chief executive officer or president. They have day -to-
day responsibility for handling all the hospital businesses.
He or she is the highest ranking administrative officer who
manages all the administrative departments associated with
financial operations, public relations, and personnel.
 In many large hospitals, a chief operating officer manages
the activities of certain departments, and a chief financial
officer guides the financial activities of the hospital. These
key administrative officers are corporate vice presidents
of the hospital.
 The huge number of employees and the extensive collection
of individual skills needed to staff a hospital calls for a
personnel or human resources department with
specialised labour expertise. This department is also
headed by a vice president for human resources. Nursing is
a great component of the hospital’s service operations, thus
larger facilities also have a chief nursing executive at the
vice president level.

14. Medical Staffs in the Hospital and Their
Functions
 Each hospital should have a medical staff with the aim to
provide medical care to the patients as per the ethical
conduct and professional practices of their membership.
The structure of medical staff is different in every hospital.
 Residential Medical Staff: These staff members remain
available for 24 hours to attend the patients. They are also
responsible for the organisational and administrative duties.
 Associate Medical Staff: These staff members include the
physicians allotted to different services similar to the members
of the active medical staff. These can be progressive as the
residential medical staff.
 Consulting Medical Staff: These staff members include
medical physicians of known professional ability.
 Honorary Medical Staff: These staff members are like part-
time consulting medical staff. These members are retired
physicians or physicians possessing a clinic and providing
nominal facilities to the hospital.

15. Associated Medical Services
 Medicine Division:
i)Internal medicine,
ii) Cardiology,
iii) Gastroenterology,
iv) Nephrology,
v) Pulmonary diseases,
vi) Psychiatry and neurology,
vii) Infectious diseases,
viii) Allergy,
ix) Skin and venereal
diseases,
x) Endocrinology,
xi) Geriatrics,
xii) Immunology, and
xiii) Paediatrics.
 Surgery Division:
i) General surgery,
ii) Obstetrics and
gynaecology,
iii) Orthopaedic surgery,
iv) Ophthalmology,
v) Otolaryngology,
vi) Dental and oral surgery,
vii) Nephrology,
viii) Neurological surgery,
ix) Cardiothoracic surgery,
x) Plastic surgery, and
xi) Anaesthetics.

16.  Radiology: It is the branch of medicine that deals with the diagnostic and
therapeutic application of radiant energy in the form of roentgen X-rays
and radium. The radiology department is headed by a M.D., who provides
services on receiving a written order by a member of medical staff.
 Radium or sealed radioactive sources can be therapeutically used by
those physicians who have been given permission in consultation with the
radiologist and/or radiation safety committee. Radioactive substances
should be handled by appropriately trained and experienced personnel.
This department includes physicians trained as radiologists, physicists,
technicians, radiotherapists, isotope -pharmacists, nurses, assistants, and
secretarial persons.
 Modern radiology departments also have facilities of sonography,
Computer-aided Tomography (CT) scanning, MRI (Magnetic
Resonance Image), etc.
 Pathology and Clinical Biochemistry Services: These services provide
the facility of collecting samples of blood, urine, sputum, faeces, etc., in
order to detect the presence of pathogenic infection or abnormality in
biochemical parameters such as sugar, urea, etc. The related processes
are done as per the instructions of the physician, surgeon, etc.
 Blood Bank: This service provides facility of collecting, processing, and
supplying blood and its products (blood plasma, etc.). A blood bank is a

17. Supportive Paramedical Services and Staff
 Nursing Services: The nursing team comprises of workers with variable
degrees of skill in nursing and are directed by a professional nurse. This
team replaces the single nurse who has done everything for the patient.
 . These were started by National League of Nursing in the U.S.A. in 1964:
 Nursing care includes health promotion, care and prevention of disease, rehabilitation,
teaching and counselling, emotional support, and treatment of disease.
 It is an essential part of the healthcare system and is performed in combination with
related medical, educational, and welfare facilities.
 The nursing team should respect individuality, dignity, and rights of every person
irrespective of race, colour, breed, origin, and social and economic status.
 Dietary Services: Food service plays an important role in hospitals. This
is also a therapeutic measure directly related to scientifically-prepared
nutritious diet meant for certain diseases. These services impose on the
clinical care of the patient.
 Plans menu for general or special diet for patients and employees,
 Selects and purchases food, Maintains relationship with food vendors,
 Receives and stores food, Prepares and distributes food,
 Maintains cleanliness and safety in the department,
 Trains and supervises the staff,
 Educates nations on dietary habits along with the medical or nursing staff, and

18.  Medical-Social Service Department: This department serves as a
link between the hospital and the patient and his/her relatives. The
qualified social worker is a discipline who focuses on the social
aspects of the patient and his/her family. The worker gives information
regarding the medical and social study of suitable patients, and their
home environmental particulars.
 Central Sterile Services: The main function of the Central Sterile
Services Department (CSSD) is to give sterile items, linens, and
equipment to wards and OT’s. The department sterilises the reusable
equipment and linens received from various wards. The department
exchanges items as per the need. The linens are sent for washing to
the laundry either directly or via CSSD, and the washed linens are
then sent to CSSD for sterilisation. These sterilised items are then
issued t o the wards and OT’s whenever they demand for.
 Medical or Patient Treatment Records: These are the systematic
documentation of a patient’s medical history and care. Medical record
is a physical folder for each individual patient as well as an information
body that contains the complete history of patient’s health.
 Drug Information Services or Centre: The aim of these services or
centre is to document drugs by extracting information about them.
Drug information is the information on physical, chemical, biological
and health care sciences collected either in written forms (i.e., books,
journals, periodicals, etc.) or conveyed by oral communication or by
electronic devices.

19.  Drug Distribution System: Every hospital use drugs
and therapeutic substances in in-patient and out -
patient departments. Bigger the institution, bigger is
the problem of procurement and distribution of drugs.
 The following two types of drug distribution system
exist in hospitals:
 Drugs are distributed to indoor patients, operation
theatres, X-ray, and other specified departments.
 Drugs are distributed to outdoor patients (i.e., who are
not admitted).
 Two more drug distribution types are:
 Dispensing of narcotics and other controlled
substances, and
 Distribution and dispensing of ancillary substances
and articles.