[The hospital of the future: origins, evolution and perspectives]

The origins of the modern hospital date back to the beginning of the XX century, following the developments in anaesthesia, control of infections, and medical science and technology. Despite continuing changes in medicine and specialisation advancements, the increasingly higher costs for medical care, the population ageing and the more demanding patient require new solutions. In many cases, primary care services can deliver minor acute disease and injury treatment, ambulatory surgery and intermediate care--such as home health and residential care--in settings that are more accessible for patients and their families. Therefore, it's impossible--as it was a century ago--to predict what the hospital of the future will look like, but the trend is towards a lean network of hospitals based on the "hub and spoke" model, with a patient-centered internal configuration and linked with a strong primary care system by shared goals, guidelines and telecommunications.