ABSTRACT In the late nineteenth century, in most industrialized countries, the coverage of social risks in general and the risk of sickness in particular came from four basic sectors with different weighting according to country: the state, the market, the traditional family network and solidarity among workers. Historians have shown that, across time, hospital systems tended to be created in developed countries where at least one of these public or private elements was prominent. Spain provides an excellent case study of how a country in Western Europe made modest progress with respect to its hospital system between the 1880s and 1930s in a context of low coverage capacity in all four of the areas that comprise the mixed economy of welfare. Changes to the hospital map occurred above all during the 1920s and 1930s with the emergence of new actors responding to new demands: companies that created hospitals for workplace victims; friendly societies; insurance companies; and medical specialists who set up clinics to attend to an emerging middle class. Despite this, the majority of the working population lacked hospital coverage due to the state’s inability to establish a health insurance scheme in a country with a predominance of agricultural workers.

中文翻译：

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西班牙医院系统中慈善事业的长期阴影，c。1870-1942 年

摘要 在 19 世纪后期，在大多数工业化国家，一般社会风险的覆盖范围，特别是疾病风险的覆盖范围，来自四个根据国家不同权重不同的基本部门：国家、市场、传统家庭网络和团结。工人之间。历史学家已经表明，随着时间的推移，医院系统往往是在发达国家建立的，这些国家至少有一个公共或私人元素是突出的。西班牙提供了一个极好的案例研究，说明西欧一个国家如何在 1880 年代至 1930 年代之间在构成混合福利经济的所有四个领域的覆盖能力低的情况下在其医院系统方面取得了适度的进展。医院地图的变化首先发生在 1920 年代和 1930 年代，出现了响应新需求的新参与者：为工作场所受害者创建医院的公司；友好的社会；保险公司; 以及开设诊所以照顾新兴中产阶级的医学专家。尽管如此，由于国家无法在一个以农业工人为主的国家建立健康保险计划，大多数工作人口缺乏医院保险。