Other regional variations in hospital development reflected regional economic disparities, especially in the South and West, where less private capital was available for private philanthropy. These non-federal short-term care institutions, controlled by community leaders and linked to community physicians to meet community needs, accounted for 82.3 per cent of all hospitals, contained more than half of all hospital beds, and had 92.1 per cent of all admissions. The term "general hospital" refers to a hospital serving patients with medical or surgical needs or conditions in contrast to other specialised hospitals, such as hospitals serving women (gynaecology and maternity), people with mental illness (insane asylums) and people suffering from long-term chronic conditions or an incurable disease such as cancer, which were often excluded from admission to a general hospital. Multi-patient wards continued to expand and became the norm in public hospitals for hundreds of years.
The earliest architectural evidence of a hospital appears to be that of Mihintale in Sri Lanka, which can be dated to the 9th century. Seamen's hospitals were established by trading companies to care for sailors who were sick and unable to work and for passengers who were ill and could not be treated or cared for on the ship. American hospitals in the 18th and early 19th centuries were funded and run primarily by wealthy citizens who considered it part of their civic duties. When someone got sick, the last place they wanted to be was in what, at the time, passed for a hospital.
Some believe the first hospitals dedicated to this purpose were in Mesopotamia, while other researchers believe they were in Buddhist monasteries in India and Sri Lanka. Introduced a week later, the bill encouraged the Assembly to establish a hospital to care for the sick poor of the province and for the reception and care of lunatics. On the other hand, the owners of the voluntary and religious non-profit hospitals did not take any share of the hospital's income. By 1965, more than 90 per cent of the large hospitals and 31 per cent of the smaller ones had intensive care units staffed by increasingly skilled nurses.
However, throughout much of history, a hospital provided shelter for the poor (hence the term hospitality) as its primary function rather than healing. The tradition of nursing developed during the early years of Christianity, when the benevolent outreach of the church included not only caring for the sick, but also feeding the hungry, caring for widows and children, clothing the poor, and offering hospitality to strangers. Although medical schools were established in Greece in the 6th century BC, it is generally agreed that the first teaching hospital with visiting physicians and scholars from Egypt, India and Greece was founded in Gondisapur, in present-day Iran, in 300 AD. If the professionalisation of nursing has had the significant effect on the quality of the hospital experience that Charles Rosenberg has suggested, changes in the nature of hospitals have had a profound effect on the nursing profession, since the vast majority of nurses practice in a hospital setting.