A complex questions with over generalizations. In the US, it is typical in a town of 5,000 people to have a 25 bed hospital. They will generally provide basic emergency services to transfer you to a larger facility.
With 25000 people services are general internal medicine (hernia, gall bladder etc.), OB, basic orthopedics. These communities will typically have one or two hospitals with a total of 200 beds.
At about 40,000-60,000 people, towns have about 400-600 hospital beds and will have almost all specialist available, most on call 24 hours a day. Very few patients are sent sent to larger facilities. The patients that these facilities cannot treat will usually be needing a high risk procedure like open heart surgery, burns, organ transplant, and gastric surgery. These patients will be sent to a larger facility. Usually a teaching hospital for the speciality they need. Is it similar in your country?
12 comments
I think reasoning in terms of population is kinda wrong, because our spaces are so different, thinking about distances is better.
No town of 5000 has a hospital here, because you can drive to a town of 25000+ in less than 30 minutes in 99% of cases.
In general there will be a major hospital in the radius of 100 km from you, wherever you are in the country.
Like u/avlas describes, it’s more based on distance and population density of an area, rather than population of a city. I found [this map](https://i.ds.at/5KcFew/rs:fill:1600:0/plain/2014/12/23/20141227-Krankenhaus-Distanz-WEweb2.png) from 2014 showing that they try to keep the distances between 50km, except in the mountainous regions where fewer people live.
All of them provide general emergency services and general care, for specialist care you’d most likely be transported to the larger clinics in the marked state capitals.
Well there isn’t really a consensus on that considering healthcare is handled by the Regional Governments and they get to decide where shit goes. Population and number of cities and their size vary a lot from region to region so.
But a small town will generally never have a hospital, only a so called “Vårdcentral” (Health Centre) that can take care of simpler stuff. It’s also supposed to be your first contact in non-emergencies.
So if they cant handle the issue they send you up to one of 3 hospitals in the region in my case. These are also emergency hospitals so if you need emergency care you also go to them. Here most shit can usually be done. They are placed in the larger cities of region in most cases.
These hospitals can do more or less everything but my region also cooperates with 2 other regions. So cases of highly specialized care such as neurosurgery, cardiac surgery and care of burn victims go to another very large University hospital roughly an hour outside our region.
The situation in Germany is similar to what the two other users have described for Italy and Austria. Hospitals are located more according to distance than based on population numbers of the town they are in.
There are rules on this, as well as the size of the hospital (which is determined by population numbers).
However, the high population density in many places, as well as the political history of the country does occasionally lead to somewhat odd situations. You can find relativly big hospitals in towns right next to each other (as in less than 20 minutes by car from town centre to town centre) because the two towns belonged to different states prior to the late 40s. By the time they ended up in the same state, both hospitals were well-established and closing down either of them would have caused public uproar.
It depends where in the country. I think most regional hubs have decent hospitals. But a regional hub in Norway can be a town of 10 000 people. I live in a city of 300 000 (Bergen) and the hospital doesn’t seem better equipped than the hospital in Tromsø, which has a population of around 80 000.
It’s also not uncommon for specialists to take up residence at a smaller hospital. I met a guy in a pub in Voss (16 000) who had been sent there from a larger town in northern Norway, because at that time the surgeon who was best at the specific type of knee surgery he needed, worked in the hospital there.
Edit: also if someone needs time sensitive emergency treatment, they just send a helicopter. Norway is rural AF and the roads are long and windy, so the helicopter pilots are kept pretty busy.
I cannot find any information about the number of beds in Swedish hospitals… and I’m not surprised, as a wide variety of treatments hospitals offer do not use beds
And it’s not something they talk about, just like grocery stores do not tell you about the number of items they carry
However… Based on my general area of Sweden ([Götaland](https://en.m.wikipedia.org/wiki/G%C3%B6taland))
+1 population — Reachable by domestic services
+1 population — Reachable by medical service taxi
+1 population — Reachable by medical assessment ambulance
500 – 1’000 — A healthcentre/GP clinic that is open a few days of the week
1’000 – 15’000 — A healthcentre/GP clinic
15’000 – 200’000 – A hospital
+200’000 – More than one hospital
It should be added that the size of healthcare is not based upon the size of cities, but instead on the size of regions
It should also be noted that each hospital, while still offering general care, is specialised in one particular area.
One hospital is specialised in cardio, another in neuro, another in joints, and so on. So you can be transported between regions (1-2 hours) if you have severe health issues
That’s very difficult to say because of the difference in density between the USA and the Netherlands. Hospitals are placed so that everyone in the country can reach a hospital within a 45min drive. This means that a small 5000 inhabitants town in a rural area can have a hospital with 250 beds, because they are the hospital for a lot of small towns, and on the other hand a suburb in a large city can have the same number of beds and services.
Rural regions have FAPs: paramedic/obstetritian stations. However, they have been “optimized away” in many places along with rural hospitals. The nearest care point for many communities is the central district hospital (think county hospital).
As for our region you have a health centre with a GP, often but not always a dentist as well as physiotherapist, dietician and other caregivers are clustered. This is found in most villages or neighborhood. You have local hospitals in every major town for a certain region. Bigger cities have multiple hospitals. And you have academical hospitals, often where specialist are clustered. As far as I know, those academical hospitals often have certain areas where all knowledge is clustered for a certain disease or treatment.
Your figures won’t match Central Europe at all because settlements with 5,000 people are medium-sized villages over here and they usually have a few general practicioners and dentists at most. This all evens out because the next city with 25,000 people is usually less than a 30 minute ride away. And at that size they have a hospital.
Also, in the Central European countries there’s universal healthcare so money isn’t a concern when you are seriously ill. In summer, we have the emergency helicopter land in our village one time per week because another idiot almost killed themselves on a downhill track that was way above their skill. They are sent to the university hospital 100 kilometres away then.
Here it’s probably more based on distance. We are such a tiny country and it’s split in provinces, every province has a “capital” (a.k.a a big city with 75k-250k people) and that’s where the major hospitals are located. I live near the capital of my province so I have no other hospital nearby. The capital city hospitals usually got all the specialists and amazing doctors. That’s where the university teaching hospitals are as well.
I know of 2 smaller hospitals in my province: 30km and 20km from the “capital” of my province. They are in 20k-ish population cities. There is really no point in having a hospital in a 5k inhabitants town here. My town is 7k I think? And I’m in 15 minutes at the hospital in the big city and 25 minutes or so in a smaller hospital. Everything is just so close in distance, it would be a waste of money and resources.
The smaller hospitals usually have a variety of services available. So you don’t need to drive 30km’s to get supportive insoles or an MRI. But for serious issues they’ll still forward you to the big city, once you are stable.
So I would say big hospitals in the “big” cities, and in general a smaller hospital in a 20k city. But I don’t think we go smaller than that.
Spain, with a territory only slightly larger than California, is divided into 17 Autonomous Communities/”States”, and each one runs its own health service, so it is quite different depending on where you are.
There are usually only hospitals as such in provincial capitals, and the smallest of the 52 provincial capital has 36,000 inhabitants. In terms of size, the largest province has 21766 km² and the smallest 1997 km².
These hospitals serve the whole province, although sometimes if there is a large population, a long distance or high demand for services, they are also opened in other cities, but they dont usually have all the services. In the rest of the towns and cities there are primary care centres, which can also be very different from each other: either they only have family doctors, or they may even have some specialist doctors and emergency services.
The criteria for building new hospitals or health centres is also unclear, usually either because of complaints from the people or because elections are coming up (in the latter case they are usually hospitals for which there is not enough money to hire enough staff, but which look good for the photo).