1. Segregation
Hospitals in many states were segregated by race until the late 1960s, and hospitals used by nonwhites had inadequate facilities. Some hospitals were also segregated by gender.
2. Public aid
Most of the hospitals were in cities — cities in the United States created so-called isolation hospitals in the 18th century — and these institutions began to receive public aid in the early 20th century.
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3. Used mostly by the poor
Until the 20th century, hospitals were places associated with the poor and where people went to die. The wealthy were treated at their homes by doctors who made house calls 100 years ago. Physicians were not paid by hospitals. They volunteered to treat the poor to help build their reputation.
4. Religious-affiliated hospitals
Religious groups, mostly in the Northeast, opened their own hospitals to accommodate dietary restrictions not met at other hospitals. Catholic hospitals didn’t serve meat on Fridays, and meals at Jewish institutions were kosher.
5. No pain management
Hospitals today devote much attention to managing pain, as patients are treated with opioids and other medications. That was not the case 100 years ago, when pain care was overlooked.
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