A Once Charitable Enterprise: Health Care in Brooklyn, 1890-1915: Dissertation Final Report and Executive Summary

摘要

This work looks at a set of charity hospitals in Brooklyn, New York between 1890 and 1915. It analyzes the social, economic and political factors which forced these facilities to become 'voluntary' institutions. The research focused on the introduction of private and pay patients, the development of private and semi-private rooms and services, and the introduction of large numbers of affiliated physicians into these formerly charity facilities. Also the development of fee-for-service and per diem, per capita public reimbursement schedules is analyzed in regard to its long-term effect on hospital governance and lay control. The effect on hospital patient services is also analyzed. As the older walking city dissolved with the introduction of electric trolleys, subways, pavements and telephone service, hospitals and doctor office services were severely affected. The thesis maintains that the very definitions of health services changed as medical goals replaced moral objectives in these previously charity institutions. It draws on annual reports, census materials, patient origin data and other qualitative and quantitative materials for its analysis.