[Tagging] Classifying hospitals (Was: Deprecate healthcare=centre)

Jerry Clough Sk53_osm at yahoo.co.uk
Mon Jan 11 14:45:16 UTC 2021

I think you need to be careful here: what counts as a hospital will vary 
greatly according to the status of the healthcare system & population 

The number of hospitals with emergency departments (a&e, trauma) is 
declining because the best patient outcomes occur in large centres with 
24/7 coverage & a broader range of diagnostic tools. Notwithstanding 
this every local closure of an emergency department is fought fiercly 
(at least in UK & Ireland).

Just because a hospital does not have an emergency department, does not 
mean that it doesnt accept emergency admissions (better thought of as 
unplanned, although some will be true emergencies). Smaller hospitals in 
the UK are now likely to be GP-led (i.e., there are no dedicated 
consultant staff, but they will cover out-patient clinics (perhaps with 
a roving consultant), minor injuries, simpler diagnostics (biopsies, 
bloods etc), day case surgery (e.g., in-grown toenails), and will have a 
number of in-patient beds. They may even offer maternity services, but 
am not sure of that. So these are still hospitals not clinics. Case in 
point & the one I know best is Campbeltown Hospital which is needed 
because it's over 200 km over poorish roads to the big hospitals in 
Glasgow & true emergencies dont get an ambulance but a helicopter.

At the other end of the spectrum there are tertiary hospitals which only 
accept patients referred from another hospital. There are quite a number 
in London, such as the Royal Marsden (cancer), the National Hospital 
(neurology), Hammersmith (national tertiary centre), and a few others 
scattered across the country (e.g., Papworth in Cambridge).

Psychiatric hospitals are also of this type, and in some countries there 
are probably still centres treating TB.

The NHS data model has precise detailed definitions of the entire 
vocabulary of healthcare, and similar work was done some 30 years ago on 
a pan-European basis (RICHE Esprit project). The former at least is a 
useful place to check ideas for tagging on OSM.

tl;dr: absence of an emergency department does not stop something being 
a hospital.


On 10/01/2021 05:15, Graeme Fitzpatrick wrote:
> Following on from Joseph's discussion re healthcare=centres, I'd also 
> like to have a similar discussion re hospitals.
> On Sun, 10 Jan 2021 at 11:56, Joseph Eisenberg 
> <joseph.eisenberg at gmail.com <mailto:joseph.eisenberg at gmail.com>> wrote:
>     If it has inpatient beds where you can stay overnight with a nurse
>     on call, 24/7, if needed, then it is an amenity=hospital.
> I've been doing some work on hospitals while also talking to our State 
> Govt about getting approval to use their data-base to update 
> everything state-wide.
> On Sun, 10 Jan 2021 at 11:34, Paul Allen <pla16021 at gmail.com 
> <mailto:pla16021 at gmail.com>> wrote:
>     In parts of the UK, "cottage hospitals" (small hospitals with a
>     minor injuries
>     unit but no A&E, and with some beds) are being phased out and replaced
>     by "integrated care centres."
> We have similar sounding Health Centres in rural areas, with some 
> named as "Hospital" & others not. The Health Dept classification seems 
> to be that if it has an Emergency Room, it's a Hospital; if not, it's 
> only a Clinic.
>     Since it is already hard enough to distinguish amenity=clinic from
>     amenity=doctors, it would be hard to add a third level of
>     outpatient facility larger than a clinic. (I would be interested
>     in a new tag for outpatient surgery facilities which have
>     specialized operating rooms but no inpatient beds,
> One of the things that I've noticed while working with them was that 
> there are a number of places tagged as hospitals.
> The doctor's offices, dental surgery, ambulance stations, pharmacies & 
> vet surgery!, that I found, are simply wrongly tagged, which is easy 
> to correct.
> I'm a bit concerned though about the other places that are more or 
> less correctly tagged as hospitals.
> As above, I think that we'd all agree that a "hospital", be it either 
> Public or Private, accommodates inpatients in a bed with 24 hour 
> nursing care, & also has an Emergency ward.
> However, there are also a number of others:
> Day Surgery Centres, where you go for an in & out surgical procedure, 
> but where you don't actually stay overnight. Some of these do have a 
> limited number of beds available so you can stay, if you're not well 
> enough to go home, but that's apparently pretty rare.
> Private facilities that aren't equipped for any form of surgery or 
> emergency, but are intended to treat people for things like drug &/or 
> alcohol dependency.
> Similar to these, dedicated mental hospitals.
> Should we distinguish better between places that you can go to for 
> emergency medical treatment, & others that can't do anything for you, 
> than just an emergency=yes?
> That would then lead to a discussion on carto re rendering them.
> ATM, all "hospitals" are rendered with the mini-Swiss flag / reverse 
> Red Cross (which I know is also somewhat controversial). Should we 
> also look at changing that?
> Thanks
> Graeme
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