City Document No. 64. TATIS REGIMINE DONATA TWELFTH REPORT OF THE TRUSTEES OF THE CITY HOSPITAL, BOSTON; WITH REPORTS OF THE SUPERINTENDENT AND PROFESSIONAL STAFF, RULES FOR ADMISSIONS AND DISCHARGES, ETC. Thomas L. Jenks, term expired April, 1876. Edward Cowles, M. D., Superintendent and Resident Physician. Visiting Surgeons. Chas. D. Homans, M. D. W. C. B. Fifield, M. D. Ophthalmic Surgeons. Henry W. Williams, M. D. Oliver F. Wadsworth, M. D. Out-Patient Department, Medical. Edward J. Forster, M. D. Thomas Hall, Jr., M. D. Out-Patient Department for Diseases of the Skin. Out-Patient Department for Diseases of the Ear. Out-Patient Department for Diseases of Women. W. E. Boardman, M. D. J. R. Chadwick, M. D. REPORT OF THE BOARD OF TRUSTEES. CITY HOSPITAL, BOSTON, April 30, 1876. TO THE HONORABLE CITY COUNCIL :— GENTLEMEN: The Board of Trustees of the City Hospital, in compliance with the Ordinances, respectfully present herewith their Twelfth Annual Report. Number of patients treated in the out-patient department, classified according to their diseases: 241 1,795 1,331 54 3,180 3,421 2,868 290 3,158 263 297 171 2261 days, 241 2,295 3,843 1,727 375 864 309 9,413 Number of visits to the Hospital made by each class : The report of the Superintendent and Resident Physician, presented herewith, contains, besides other information, a statement of the expenditures for the year, and is accompanied by the reports of the medical staff. These reports give details in regard to the number of patients treated in the Hospital and as out-patients during the year, with classified statements of their diseases and the results of treatment. The whole number of patients in the Hospital during the year was 3,421, and they were under treatment at an average of 241 days each, making a total of 82,831 days, or 11,833 weeks. The entire cost of maintaining the Hospital during the year, including every expenditure, was at the rate of $9.68 per week But of the patients enumerated above, 71 paid for 102 weeks' board Leaving, therefore, the sum of 7 $114,545 98 1,276 28 $113,269 70 as the cost to the city of treating 3,350 non-paying patents for a total of 11.730 weeks, which is at the rate of $9.65 per week. But by averaging the net cost of maintaining the Hospital for the year, among all the patients treated, we find that the average cost to the city of board for each patient was $9.243 per week. This cost includes all expenditures in excess of income and value of stock on hand, including cost of new equipment. During the past year the Hospital has been in what may be called a state of transition, owing to extensive building operations; and this has in various ways affected the results of the year, and to some extent destroyed the usual bases of business and averages. The Hospital has been enlarged by the addition of five new buildings; two for medical, two for surgical, and one for culinary purposes. Three of these buildings are already occupied, and the others are nearly in readiness. The heating apparatus has been remodelled throughout, and largely increased in capacity. Many radical defects of drainage and ventilation in the older buildings have been remedied, while the new structures contain all improvements and appliances that experience and observation had proved valuable for the care and safety of patients. Other changes are making and to be made, and when all is accomplished, the Trustees hope this institution may at least compare favorably in point of equipment, discipline, and efficiency, with that of any other city. As the subject of economy is one now exciting much interest, and has been raised particularly in reference to the conduct of the Hospital, it may not be improper to observe, that the aim of the Trustees has been to prevent waste or extravagance, and to reduce the expenses to the lowest point commensurate with efficiency. It will be seen, from the above statement, that the average cost of treatment is less than last year. The Trustees have no particular desire to institute comparisons of cost with that of other institutions. Neither have they any fear of the result if any are curious enough to make them. It is presumed that the city of Boston desires that the suffering poor shall have every care and attention their situation may require, and that the Hospital shall yet come up to the standard contemplated by its founders, and prove itself a noble charity worthy of the city. * It is believed that with the Hospital as now arranged not only increased capacity and efficiency, but less average cost of treatment per capita, will result. The income from paying patients has been falling off in the last years. This is owing to various reasons, one of which is, that paying patients have been obliged to give way to those too poor to pay. The Hospital has had more demands upon it than could be met by its capacity. The new buildings largely increase its capacity, adding/85 beds, and there can now be comfortably accommodated 375 patients. In the enlargement due regard has been had to the necessity of rooms for paying patients, and they have been provided; so that any now desiring rooms at a reasonable, moderate rate, can be furnished with them. The price of board will probably range from five to twenty dollars per week. The construction of the new buildings, and the changes necessitated thereby, has of course been a work of much care *The number of beds has heretofore been 230, but of these 40 were in basements, which have been abandoned for sanitary reasons. |