Talk:List of largest hospital networks

Chang Gung Memorial Hospital
Per this link (source), the Chang Gung Memorial Hospital capacity listed here on Wiki is wrong. The article lists it as 10K beds, but the source says just 3.7K for the hospital; the 10K number is from combining 4 other hospitals. Per the header, this article is for individual hospitals only. If there are no objections, I'm going to update the article when I'm next logged in. 162.129.251.30 (talk) 19:23, 24 June 2019 (UTC)

China
If you want to make a list of hospitals with thousand beds which makes it seem as if obscure hospitals in China and other third world countries, with like 100 doctors, are the world's most important hospitals, do it another article. This is conceived by the article creator as a list of hospitals by staff members and is a completely different article. --Anneamel (talk) 16:20, 23 August 2019 (UTC)
 * Bed capacity is by far a more widely-used metric in determining the size of a hospital. This is why even the few sources you gave when you first created the article ranked hospitals primarily according to bed capacity, with staff size only as a secondary statistic. Staff size can vary from hospital to hospital depending on many factors: whether the hospital outsources certain services, their (or their country's) definition of an employee, what kinds of staff or work arrangements are mandated by local law, or whether research staff are counted as part of the hospital or a separate subsidiary. A bed, on the other hand, is fairly objective. One bed always equals one inpatient, and that gives a good gauge of how many individuals it can accommodate as part of inpatient care. In any case, I find at present no need for us to resort to separate articles given that this list is still relatively short and can accomodate statistics on both bed capacity and staff size. Perhaps in the future when we find that the two statistics are too disparate and the list too long then we can consider an article WP:SPLIT.
 * I am not sure what you mean by "obscure hospitals in China and other third world countries, with like 100 doctors", or why that argument is even relevant here. An article that is about the largest hospitals in the world should never be about "first world" hospitals only, and as far as I am aware none of the "third world" hospitals listed there only have "100 doctors". If you have reliable sources on their staff size, I am keen to hear it as it should be added into the list as part of Wikipedia's requirements of WP:VERIFIABILITY.
 * In addition, nobody is asserting that being the largest hospital equates to being "the world's most important hospital", other than you. Bigger is not better, but that's not what this article is saying, either. It's just listing verifiable information and letting readers draw their own conclusions. If you believe that only "important hospitals" (as defined by your own unknown criteria) should be highlighted here, then you must establish a WP:CONSENSUS on what the criteria for determining what these "important hospitals" should be, and whether we should even be applying such criteria to begin with. Personally, I believe having a hospital that has the capacity to care for more than a thousand sick people at a time regardless of whether they live in a rich or poor country suffices for me to consider it an "important hospital".
 * I would also like to remind you that Wikipedia is an open encyclopedia. While I thank you for your initial efforts at starting this article, you do not WP:OWN the content, and all editors are welcome to tweak the content and focus of the article in order to ensure that it best fits the objectives and policies of Wikipedia. Thank you. Epistulae ad Familiares (talk) 17:01, 23 August 2019 (UTC)

The size of a hospital can be measured in different ways, and a comparison poses some challenges, in some cases greater than in others. Two basic ways of looking at it are the
 * size of the organization
 * size of the building(s), which I don't think is very useful since a large building in itself isn't necessarily a good thing, and the quality of the building and equipment is generally more important, but still, it's possible to make a list of hospitals by building size

The size of the organization is most commonly measured either by
 * bed capacity
 * number of staff

Number of staff can be broken into number of doctors and other specific groups, including people (full-time equivalents) involved in for example research.

Bed capacity is often used as a simple way to measure the size of the organization in developed countries, because in these highly regulated countries, a bed is associated with a certain capacity for treatment, including a certain number of doctors and nurses. It's not the bed in itself that is important, but the capacity it is associated with, that boils down to mostly doctors and nurses. Bed capacity is a reasonable way, though not the only way, to measure the size of hospitals in highly regulated countries where each bed is associated with a reasonable level of capacity/staff.

My preferred version has Johns Hopkins at the top. It is widely regarded as one of the world's top hospitals, also by size. The problem with a list now dominated entirely by hospitals very few people have heard of in China and other developing countries is that there isn't a reasonable correlation between number of literal beds and the size of the organization in these hospitals. Some hospitals with a suspiciously large number of beds in places like China or India or Africa can have maybe a hundred doctors. They can buy a large building and a ton of literal beds, but they don't have "hospital beds" as the term is used in a western sense, and the reality is that the hospital organization is miniscule compared to e.g. Johns Hopkins when we look at the number of doctors, nurses, capacity for treatment in general, research activity and so on.

This issue is in many ways comparable to reputable academic journals vs. low-quality predatory journals published, typically, in the very same countries as we are discussing here. They are not the same as journals with rigorous peer review and quality standards in western countries. Most sources, including Wikipedia, don't use superficial and misleading criteria that portray them as just the same, but place emphasis on criteria focused on quality, such as inclusion in Pubmed etc.

When measuring hospital size in both developing and developed countries staff number, though not perfect either, is generally more relevant and accurate than "literal bed" capacity alone because bed capacity can mean so different things in different parts of the world. There can be a difference in the quality of staff members too, but generally, it makes more sense to compare two doctors than one bed with a dozen people attending to it vs a bed with a quarter of a person responsible for it, and it is a far more uniform criterion. --Anneamel (talk) 04:10, 24 August 2019 (UTC)


 * My preferred version has Johns Hopkins at the top. - This is a non-starter. It is not the role of Wikipedia to arbitrate and decide that the size of hospitals must be arranged in such a way that a specific hospital from a "developed country" must rank at the top, simply because one user believes it in their own worldview to be the best hospital. This article was titled "list of largest hospitals", and it therefore follows that the hospitals are ranked by the metric of size, not by the metric of good-ness, whatever one may interpret it to be.


 * While I accept that it may be true that medical care may be poorer in some hospitals than others, that again misses the point of this article. This is not the article for that. I reiterate again - this article ranks hospitals by size, not by their quality of care. If one wishes to discuss whether the metric of size should be staff or bed numbers, I will happily engage in that discussion. However, I will not offer any consensus to the deletion of sourced entries on the basis that they do not fit another user's preferences of what an ideal hospital is.


 * When measuring hospital size in both developing and developed countries staff number, though not perfect either, is generally more relevant and accurate than "literal bed" capacity alone because bed capacity can mean so different things in different parts of the world. There can be a difference in the quality of staff members too, but generally, it makes more sense to compare two doctors than one bed with a dozen people attending to it vs a bed with a quarter of a person responsible for it, and it is a far more uniform criterion. The fact remains that most lists comparing hospital sizes (including both lists given at the point of creation of this article) rank hospitals by bed numbers rather than staff numbers. Per policy, Wikipedia follows what the sources say, and is not a publisher of original thought, even if an individual editor may have his/her own ideas and personal speculation about it. Epistulae ad Familiares (talk) 07:32, 15 September 2019 (UTC)


 * There is no consensus for your proposed change. Please refrain from attempting to change the order without consensus. This is a list of hospitals by staff number. Feel free to create an article with a different topic. --Anneamel (talk) 07:42, 15 September 2019 (UTC)


 * Seeing as we are unable to come to an agreement despite my attempts at bridging a compromise, and your continued invocation of your WP:OWNERSHIP of the content on the basis of your role as page creator to impede efforts at improving the article, I shall therefore be opening a WP:RfC to allow for further discussion and development of a community-based consensus on this topic. Epistulae ad Familiares (talk) 07:51, 15 September 2019 (UTC)
 * The only ownership behaviour that is taking place here, essentially an attempt to hijack an article and prevent all improvement and further work on the article by me (its creator), is the one by you. Your bizarre claim that your version was the "stable" version merely because I had graciously, and in vain, waited for a few weeks (end of August until mid September) for a response to my above comment before reverting your unilateral attempt to change the order without discussion and consensus, really was the final straw here. But it is probably a good idea to invite more comments from others. --Anneamel (talk) 08:24, 15 September 2019 (UTC)

RfC on ranking criteria

 * The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Should the list be ranked according to staff size or bed numbers? Epistulae ad Familiares (talk) 07:47, 15 September 2019 (UTC)
 * Staff size is preferable as the default order as a far more uniform criterion in a list that covers very different hospitals in very different parts of the world: This list was conceived as a list of hospitals by staff size. While it is possible to measure the size of hospitals by many different criteria – staff size, number of beds, building size and so on (someone already wrote a list of tallest hospitals) – the size of the organization is the most uniform criterion in a list where "bed capacity" can mean wildly different things. Staff number and bed capacity are both common criteria; in general hospitals are frequently measured by bed capacity in highly regulated developed countries where a "hospital bed" doesn't primarily refer to the physical bed, but to the capacity associated with perhaps a dozen staff members attending to that bed; in essence this measure, in such highly regulated countries, is ultimately derived from the staff, not from the physical bed. The problem arises when we attempt to compare a hospital with 20,000 to 30,000 employees with hospitals in countries where the number of physical, literal beds isn't associated with the size of the organization (staff)/capacity in this way. Some hospitals in developing countries may be a building with a large number of physical beds but just a handful of doctors, and a really small hospital organization (in terms of both staff, economy, and capacity in general).
 * For instance, a ranking by number of physical beds places First Affiliated Hospital of Zhengzhou University at the top of the list; the article on that hospital is very short, has only one interwiki link and it is clearly a relatively unknown hospital of highly dubious comparability with well-known large hospitals; at the same time it has no information on number of staff and claims a bed capacity of 7,000, a very suspious number (seven times the number of the bed capacity of the world's largest hospital by staff number, Johns Hopkins Hospital) that probably indicates that it has cramped rooms packed with physical beds with only a fraction of the staff members and organizational size of a large hospital such as Johns Hopkins which has over 30,000 staff members according to the article (also: compare article size, number of interwikis). (China has an "extremely unbalanced" health care system with many "low-tier hospitals" with fairly appalling conditions, that also struggle to attract patients; at the same time the more affluent in China use the services of better hospitals that don't claim 7,000 hospital beds)
 * It makes more sense to compare two doctors (or other staff members), than to compare a hospital bed at Johns Hopkins Hospital with a dozen people attending to it to a physical hospital bed with less than a quarter of a person attending to it. Staff size captures the actual organizational size far more reliably when comparing hospitals where bed capacity doesn't have anything near the same meaning. When we sort by staff size, well-known, very large hospitals such as Johns Hopkins Hospital with long articles and numerous interwiki links end up on top, rather than hospitals few people have heard of with stub-like articles; while this is not a deciding factor in itself, it's an indication that we are on the right track.
 * In many ways this problem has some similarities with the dilemma faced by traditional systems of ranking academic journals as a result of the new problem of predatory journals based in exactly the same countries that pose a problem of comparability here. Some (but not all) hospitals in places like China could be said to be "predatory hospitals" with inflated claims of bed capacity that don't really reflect their capacity for medical treatment based on recognised standards of medical care, while no serious hospital in any developed country would claim, or even be allowed to claim by government regulators, 7,000 "hospital beds" unless they had a huge number of doctors and other employees too. --Anneamel (talk) 08:28, 15 September 2019 (UTC)
 * Staff size Per rationale provided above. Comatmebro (talk) 05:25, 26 September 2019 (UTC)
 * Staff size - Keep as is default order. If we were talking about actual size, there is already a page for that as noted above.  Meatsgains (talk) 00:50, 9 October 2019 (UTC)


 * The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

RfC on inclusion criteria
Should hospitals that are obscure or from developing countries be excluded from the list? Epistulae ad Familiares (talk) 08:02, 15 September 2019 (UTC)


 * Comment: This doesn't seem like a serious request, as there has been no proposal to "[exclude hospitals] from developing countries". This is a list of hospitals by number of staff, and we don't exclude hospitals from the list if they have a verified staff number that merits inclusion. Of course, the problem with some institutions is that little information is available about them, and when a little known hospital with a very short stub article, a single interwiki link and no information on number of staff is suddenly portrayed as the world's largest hospital, it's a problem, but probably related to how we sort the list rather than its inclusion per se, and perhaps even a sourcing problem. --Anneamel (talk) 08:41, 15 September 2019 (UTC)

Comments post-Rfc expiration
Epistulae ad Familiares, now that your Rfc has expired, a couple of comments: Good luck, Mathglot (talk) 01:48, 22 October 2019 (UTC)
 * Where's the previous discussion on this? Had I gotten here earlier, I would have recommended an immediate procedural close to the Rfc. Partly for reasons that Anneamel elucidated above, and partly because heading straight for an Rfc with little, or no prior discussion doesn't show due diligence in preparation. See WP:RFCBEFORE.
 * Secondly: if you're not familiar with it yet, have a look at Stand-alone lists, and please initiate a discussion (not an Rfc, but a broad discussion) about what sort of membership criteria you want to have for your list. Ideally, you'd want to establish some consensus about this, from more than just a couple of editors. You can poll previous major contributors at this article (ask, if you're not sure how to find them), and you can leave appropriate, neutral notification at WikiProjects to attract more eyeballs to your discussion.

Completeness
The Mayo Clinic seems to have 63.000 employees according to its own article, but isnt listed here, despite employees stated as a primary inclusion criterion. Any specific exclusion reason ? RScheiber (talk) 09:02, 16 March 2020 (UTC)

Mayo Clinic seems to be a hospital network with hospitals spread across Minnesota, Arizona and Florida (with distances comparable to London–Moscow), rather than a single hospital in the sense of this list (which is a unified organization in a particular location such as a city). --Anneamel (talk) 20:43, 25 March 2020 (UTC)

Wilric20 (talk) 18:30, 28 April 2020 (UTC)== Order of the listings ==

I'm aware this was brought up in another thread, but I'm a little confused as to the order in which these are placed at default. If this is organized by bed count (which it seems there is a consensus that bed count is most important among these stats) then why is the Mayo Clinic so far down? Other users have stated it is because the Clinic is a set of hospitals in three states, but then why is it under the title "Mayo Clinic (Rochester)"? (Rochester, MN)