Theodore M. Porter
Search for other papers by Theodore M. Porter in
Current site
Google Scholar
PubMed
Close
Asylum accounts in health and in money
Abstract only
Log-in for full text

The state-supported mental hospitals that sprung up in abundance in Europe and North America from about 1820 became founts of data and statistics. Doctors always insisted that the asylums were medical institutions, and on this basis, they distinguished administrative accounts, denominated in money, from medical tallies of patients. These institutions, however, were seriously expensive, and as they grew, ever more so. Medical administrators could never ignore the relationship of asylum costs to patient outcomes. A few doctors even presented numerical ratios of costs to cures as the ultimate justification for asylum care – though they often added that inadequate or delayed care was disadvantageous even from the standpoint of financial costs alone. Any such calculation depended data routines and conventions of calculations, none of them straightforward. The numbers, in fact, were not always passed by without criticism, especially since the dubious statistics of one institution tended, by comparison, to show others in an unfavourable light. Hence, although these accounts were often presented in reports as routine and unproblematic, and even on occasion as recipes for effortless administration, they were condemned at other moments as groundless or absurd. Such criticism did not owe to any knee-jerk rejection of numbers by doctors. The necessity of statistics in this and other fields of public health was widely acknowledged. The problem was that doctors as well as administrators were almost compelled to look to the accounts for something they could never provide, a numerical basis for fixing the benefits of treatment.

  • Collapse
  • Expand

All of MUP's digital content including Open Access books and journals is now available on manchesterhive.

 

Accounting for health

Calculation, paperwork, and medicine, 1500–2000

Metrics

All Time Past Year Past 30 Days
Abstract Views 360 160 55
Full Text Views 37 30 0
PDF Downloads 27 18 0