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By the 18th century, centralization was the trend in medicine because more and better educated doctors were requesting improved facilities.
Cities lacked the budgets to fund local hospitals, and the monarchy wanted to end costly epidemics and quarantines.
Joseph attempted to centralize medical care in Vienna through the construction of a single, large hospital, the famous Allgemeines Krankenhaus, which opened in 1784.
Centralization, however, worsened sanitation problems causing epidemics and a 20 % death rate in the new hospital, but the city became preeminent in the medical field in the next century.

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