Brackenridge Hospital, in Austin, the oldest public hospital in Texas, opened on July 3, 1884. The City-County Hospital, as it was called, was jointly owned by the city of Austin and Travis County until 1907, when the county withdrew its support. The two-story stone building was built at a cost of $10,000 on a city block in the northeast corner of Austin set aside for a hospital when the town was laid out in 1839. It had a maximum capacity of forty patients. Austin doctors had tried for fifteen years to provide Austin residents with hospital care, but financial problems had forced their establishments out of business.
In 1915 a new forty-five-bed facility was completed, and between 1929 and 1941 the addition of wings on the south, west, and north sides raised the bed capacity to 208. The size of the hospital gradually increased until a $43 million, 363-bed structure was built in several phases during the 1970s, just west of the site of the original building. City Hospital–its name after 1907–became Brackenridge Hospital in 1929, when the city council renamed it in honor of Dr. Robert J. Brackenridge, who had served as chairman of the hospital board, led the campaign to finance the 1915 hospital building, and worked for many years toward improving medical care in Austin.
Brackenridge Hospital offered Austin's first intercranial and open-heart surgery in 1948 and 1961. The city's first intensive-care unit opened there in 1960, its first cardiac-care unit in 1971, and its first alternative birth center in 1978. In addition, the Brackenridge Emergency Room, the regional trauma center for a ten-county area, treated an average of 70,000 patients annually during the early 1990s. Brackenridge also housed the area's first nursing school, which was established in 1915 and operated by the hospital until 1984, when Austin Community College assumed responsibility for the program. After beginning an education program for interns and residents after World War II, Brackenridge became a fully accredited teaching hospital in the mid-1950s.
As a public hospital, Brackenridge has always sustained a good deal of public scrutiny and has always had financial difficulties. As the hospital grew in the twentieth century, problems grew with it, and the administration of the hospital became increasingly politicized. When Brackenridge lost over $6 million in the 1975–76 fiscal year, the city council considered selling the hospital or leasing it to a management firm. After months of debate, however, the city council voted in 1978 to retain ownership and control of Austin's only public hospital. In 1993 there were 399 beds in the general hospital and 82 beds in a free-standing children's hospital, attended by a staff of approximately 1,900. In 1992 the hospital's average daily census was 253, and outpatient visits numbered 107,000.