Exploring the World's Oldest Hospital: Azienda Ospedaliera Universitaria Senese Files IPO Prospectus

The earliest prototypes of hospitals are generally believed to have been established in ancient Roman times. Archaeological discoveries across various sites in Europe have revealed separate wards connected by corridors, along with relatively advanced sewage systems. However, if archaeological ruins are excluded, the world’s oldest hospital that has maintained an uninterrupted lineage and remains operational is the Siena University Hospital (Azienda Ospedaliera Universitaria Senese), founded in 1090.

Siena, an ancient capital of Tuscany, rivals Florence in fame. Their relationship resembles the legendary rivalry between Zhou Yu and Zhuge Liang, characterized by constant opposition and seemingly inherent incompatibility. In the early 13th century, numerous wars erupted between the Guelphs of Florence and the Ghibellines of Siena. Although defeated Siena gradually lost the splendor it once shared with Florence, it still left behind the world’s first public hospital, the would-be largest cathedral in the world (based on design plans) that was never completed, and the world’s oldest bank, Banca Monte dei Paschi di Siena.

The Siena University Hospital, formerly known as the Santa Maria della Scala Hospital, is a church-affiliated hospital established in 1090. It predates the Divriği Hospital Complex in Turkey, a UNESCO World Heritage Site, by nearly 200 years. Recognized as the oldest hospital in the world, it was once one of the largest hospitals in Europe and currently stands as the largest hospital in the Tuscany region.

For nearly 900 years, the hospital has been situated directly opposite Siena Cathedral. The bench area where many tourists visiting the cathedral rest is located behind the hospital’s original site. It is worth highlighting Siena Cathedral itself, which was built in the 9th century on the ruins of an ancient Roman temple dedicated to Minerva. Its exterior presents a unique and beautiful blend of Romanesque and Gothic styles. The lower section, with its three main portals, is predominantly Romanesque, while the upper section features a tall, elegant Gothic design. At the center lies a magnificent stained-glass rose window, making it one of the most grandiose examples of Romano-Gothic hybrid architecture since antiquity. Had it not been for the plague that struck Siena, this would likely have become the largest church in the world.

Siena Cathedral

Since 1970, the hospital has relocated from its original downtown site to the suburbs, with the former premises converted into the Santa Maria della Scala Museum. The museum offers a concise display of the hospital’s original appearance and various artifacts, featuring a lighting design that is highly distinctive among Italian museums.

Behind the bench where pedestrians rest is the original site of the hospital.

Siena University Hospital currently generates an annual revenue of approximately €150 million. With 800 beds, it admits 40,000 inpatients and serves 3 million outpatients annually, primarily catering to the Tuscany region. The current campus is situated on a small hill in the suburbs and comprises five main buildings, each painted in a distinct color. While interconnected, each building houses its own examination rooms, operating theaters, and outpatient clinics. Five brightly colored landmark lines are painted on the floors of the lobby and corridors, guiding patients to various buildings and departments. These vibrant markings are highly visible and complement the flooring of Siena Cathedral. The overall hospital environment is clean, bright, and comfortable.

Exterior View of the New Campus of Siena Hospital (Image from the Internet)

The Pediatric Growth and Development Clinic at Siena University Hospital is highly renowned in Europe and was a key focus of our visit. Specialized expert clinics are held on Mondays and Wednesdays. Each session typically sees 4–6 pediatric patients, with an average consultation time of approximately 45 minutes. On average, two new appointments are added per week. The main conditions treated include growth and developmental issues in premature infants, short stature due to growth hormone deficiency, precocious puberty, and obesity. Many neurologists from Beijing Children’s Hospital have completed advanced training at this clinic.

Interior View of the New Campus of Siena Hospital

Preterm infants with growth and development issues constitute the largest patient population. These patients are generally managed through regular scheduled appointments with pediatric endocrinologists, with follow-up visits every three months. Their growth curves can be reviewed at any time in their medical records. Through reasonable nutrition and exercise interventions under the guidance of physicians and with the support of therapists, these children can catch up on their developmental progress.

Here, you can observe therapists engaging in continuous communication and interaction with children, followed by physical and occupational therapy (PT/OT) training. Various toys are placed within reach of all children, and the consultation rooms are adorned with numerous cartoon illustrations. For longer examinations or treatments, animated cartoons are continuously played on PAD screens.

Unlike in China, children here receive appropriate anesthesia during blood draws to prevent pain and panic. CT scans, X-rays, and other imaging films are rarely seen; instead, patients’ test results are stored on CDs and in information systems, allowing electronic access to records at any time.

Pediatric wards are equipped with companion beds and feature soft, soothing color schemes. Volunteer "clown doctors" perform in the hallways to bring surprises and joy to the children.

The World’s Oldest Hospital: Though Steeped in History, It Feels Vibrant and Youthful

[The author of this article is Zhao Yang, currently serving as the Director of Medical Consulting and Operations at Cheung Kong Holdings. He has many years of experience as a consultant.]

The views expressed in this article are solely those of the author and do not represent the position of VCBeat.