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August 14, 1954


JAMA. 1954;155(16):1379-1382. doi:10.1001/jama.1954.03690340001001

The elementary principles of home care have been applied since the dawn of time and have expressed themselves from first to last in a variety of forms, unorganized and organized, primitive and modern, indiscriminately and discriminately. The hospital, or institutional, method of caring for the sick was a much later phenomenon in the history of medical care. It came into existence for the purpose of transferring the patient out of his home, because, for one compelling reason or another, this seemed to be desirable. A burden was thus lifted from the shoulders of the family under a policy of service that set the home and the hospital apart. There was no sharing of the responsibility; it was either one or the other. Under pressures of many kinds the hospital has taken liberties with its terms of reference. It has, in fact, exhibited a high degree of selectivity and exclusiveness as

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