Model General District Hospital

The increase in the world population, antibiotic resistance, and pandemics make healthcare more critical. To build a healthcare infrastructure in a country, the WHO has developed a system that divides public healthcare into different levels. The system is based on the General Practitioner (GP) for the first line of care. If the GP is not sufficiently equipped to handle the case, a hospital is required. This would typically be a general district hospital located near the area where the patient lives.

A District Health System based on Primary Health Care is a more or less self-contained segment of the National Health System. It primarily consists of a well-defined population living within a clearly delineated administrative and geographical area, whether urban or rural. It includes all institutions and individuals providing healthcare in the district, whether governmental, private, or traditional.

The District Health System, therefore, consists of a wide range of interrelated elements that contribute to health in homes, schools, workplaces, and communities through the health and other sectors. It includes self-care and all health workers and facilities, up to and including the hospital at the first referral level, along with appropriate laboratory, diagnostic, and logistical support services. The component elements must be well coordinated by an officer assigned to this role in order to integrate all these elements and institutions into a comprehensive range of promotive, preventive, curative, and rehabilitative health activities.

The significance of this definition lies in the understanding that the district hospital cannot and should not operate in isolation from other health services and providers in the district. The district hospital is considered synonymous with a first referral level hospital. The first referral level hospital is responsible for a district, i.e., a defined geographical area with a specific population, and fulfills the following functions:

• Supporting other health services in the district (acting as a referral center for primary care health facilities, providing supervision and training, and participating in the District Health Management Team).
• Delivering hospital-based services (diagnostic, therapeutic, and institutional care).

A suitable approach to a service concept depends on the specific characteristics of a hospital, healthcare region, or healthcare system. The first step focuses on creating a model secondary healthcare treatment facility, in line with governmental laws and strategic healthcare planning for the coming years. The concept of this Model General District Hospital is part of the District Health System as defined by the WHO. Our solution aligns with the WHO definition.

The model general district hospital should offer a broad service package for the inhabitants of its district, not based on excluding medical disciplines, but based on patient severity, chronic diseases, etc. The scope of medical disciplines should be clearly defined. The first point to address is a general understanding of the specialisms that will be included in the hospital. According to OECD Health Data, specialisms are categorized into medical specialists and other disciplines. Medical specialists are doctors who specialize in the diagnosis (but not the surgical treatment) of physical disorders and diseases.

The assumptions of the model general district hospital are:

Adherence          :                              175.000 people

Beds                      :                              300 pcs.

Net Area              :                              17.000 m²