The History of Hospital Administration

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early medical sketch for a hand deviceThe concept of hospital administration seems obvious and necessary in modern medical practice. This wasn’t always the case. Although early institutions aiming to provide cures for health maladies have been around since the time of the ancient Greeks, hospitals as we know them have only been in existence for about a century and a half.

Modest Beginnings

In the fall of 1899, eight hospital superintendents met in Cleveland to formulate a plan to establish guidelines for medical practices. This meeting resulted in the formation of The Association of Hospital Superintendents, whose goal was to increase the dialogue among hospital administrators.

For the first eight years, the association was relatively exclusive. The private club created by the original eight members did not allow assistant superintendents or anyone else involved with hospital management to join. In 1906, membership rules were loosened to allow executive officers and others who ranked below the superintendent to join but without vote-casting privileges. Also at this time, the name was officially changed to The American Hospital Association.

Dynamic Vision

Even over 100 years ago, healthcare administrators were trying to lower costs, as evidenced by the new language of the 1907 AHA’s goal, which was “The promotion of economy and efficiency in hospital management.” History shows us that although health care costs may not be inherently high, the struggle to keep them affordable has been steady going for over a century.

Through the years, the language of the American Hospital Association’s mission statement has changed, often in accordance with new social and political attitudes of the populace.

In 1917, the stated goal was changed as a precursor to the allowance of institutions into the AHA. Although “institutional care” and “hospital management” were included, the fact that the word “efficiency” was used twice adds to the evidence that hospitals have been battling costs since the beginning.

In 1937, perhaps owing to new vaccines for yellow fever and typhus, the language of the AHA mission was changed to emphasize education and scientific research.

A number of initiatives throughout the 1940s aimed at providing better patient care raised the profile of the AHA. With a growing influence on national health policy, the AHA changed its mission once again in 1951. The new statement promised to “promote the public welfare through the development of better hospital care for all the people.”

Meeting Challenges

Throughout the latter half of the twentieth century until the present day, healthcare administrators have had to meet myriad challenges relating to patient care, rising costs, advances in technology and politics.

With the advent of Medicare and Medicaid, hospital administrators were tasked with finding ways to integrate new payers into already complex and diverse cost management systems. In broader terms, they were attempting to increase the number of Americans who had health insurance. When Medicare came on the scene, fewer than half of elderly Americans had health insurance.

In 1978, the AHA formed a political action committee after increasing involvement in national health policy caused a need for discussions with politicians in Washington D.C. Also around this time, Gail L. Warden, executive vice president of the AHA, outlined the shifting cultural change in medical care that allowed hospitals to become centers for community health and “major social institutions, adding value to their communities.”

Healthcare management through the American Hospital Association became a necessary part of healthcare when hospitals began proliferating throughout the US and doctors realized a need for consistency and communication as part of giving Americans better medical care. In 2016, it remains a fast-growing field that shows no signs of deceleration.