The Evolution of Facility Design in 1960s & 1970s / 1980s & 1990s
1960s & 1970s
In the 1960s, the evolution of health care facility design was characterized by an increase in the public expectations for medical attendance and nursing practice, along with the recognition of physicians and nurses. For example, health care facility design established the application of Medicare and Medicaid Services in the 1960s (Kisacky, 2019). In that regard, the evolution focused on the provision of health care services to the marginalized population such as the poor and the elderly. During the period of the 1960s, health care facility design also recognized the Kerr-Mills Act of 1960 to care for elderly people. Besides, over 95% of big healthcare facilities and 31% of smaller facilities had increased the number of nurses in intensive care units by 1965.
In the 1970s, the evolution of health care facility designed was witnessed when at least 7,123 health facilities were listed in America by the American Hospital Association. Moreover, in the 1970s, there was a significant shift that occurred in hospital utilization (Kisacky, 2019). Mainly, the number of beds in tuberculosis, psychiatric, federal, and long-term care facilities reduced. On the other hand, community hospitals increased the number of bed capacity through incentives offered by the government.
1980s & 1990s
In the 1980s, the evolution of health care facility design was witnessed via the growth of for-profit hospital networks. The impact of that growth was characterized by an increase in the vulnerability of smaller health care institutions with not-for-profit arrangement. In the same decade, over 600 community hospitals collapsed. The decade also witnessed the formation of large hospital systems by not-for-profit and for-profit institutions. In the 1980s, the evolution occurred through change in configuration, control, and ownership of health care services (Kisacky, 2019). The distinction between non-profit and for-profit institutions created a huge pool of investors who aimed to own their health facilities. It also resulted in a decline in the number of investors for non-profit health care facilities.
In the 1990s, the central theme of health care facility design was cost containment. In that regard, there was an evolution of the balance of power where services changed from caregivers to buyers of care. Besides, Medicare and Medicaid played a significant role in developing these hospitals (Kisacky, 2019). Moreover, the decade witnessed changes in health care to nursing homes for the patient with chronic diseases, and ambulatory care facilities for acute care, along with outpatient services.