The modern hospital bears little resemblance to its ancestors.The charitable institutions of the 19th century mainly tended,rather than treated, the sick, and they served mostly poor patients,whereas the wealthy received care at home. The transformationof hospitals "from places of dreaded impurity and exiled humanwreckage into awesome citadels of science and bureaucratic order"1occurred during the 20th century, thanks to scientific advancesand the maturation of the medical profession and the healthinsurance industry.2 Hospitals today are big businesses thatderive most of their revenues from paying patients and healthcare insurers.
From the Harvard School of Public Health (D.M.S., M.M.M.) and McDermott Will & Emory (C.M.J.) — both in Boston; and Aetna, Hartford, CT (T.A.B.).
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