title: Health care in the distended society: the American hospital in its social contexts.
abstract: The hospital at every stage in its development has been a product of social, political, cultural, and economic forces as well as a reflection of the kind of medical and scientific knowledge available in a given era. That we have as many hospitals as we do, that they are organized and financed the way are, that they practice the kind of medicine and provide the services they do (and that they now face the crises they do) is a result of past decisions in which health concerns sometimes played only a marginal role. Institutional inertia--the fact that institutions once set in motion cling tenaciously to life--means that a set of historical facts which have little to do with health care has saddled the United States with a hospital system that now distorts our health care expenditures and even affects how we think about disease and health.
mesh_terms: D003159:Community-Institutional Relations / Q000639:trends*; D005060:Europe; D049671:History, 18th Century; D049672:History, 19th Century; D049673:History, 20th Century; D006761:Hospitals / Q000266:history*; D012922:Social Change; D012923:Social Class; D012959:Socioeconomic Factors; D012962:Sociology, Medical / Q000266:history*; D014481:United States