After hours case mix at George provincial hospital emergency centre: a descriptive study
Thesis (MFamMed)--Stellenbosch University, 2011.
ENGLISH SUMMARY : Introduction: Emergency care of patients in South Africa has become a priority, with the establishment of emergency medicine as a specialty, developing a triage scoring system, and upgrading facilities and services. The Western Cape Comprehensive Service Plan stipulates that ninety percent of health care should be offered at level 1 (primary and district) health care, eight percent at level 2 (general specialist) care, and two percent at level 3 (super specialist) care. It is suspected that a significant proportion of primary health care patients are presenting after hours to level 2 facilities, like George hospital. Little is known about the nature or acuity levels of patients presenting after hours to the George provincial hospital Emergency Centre. A retrospective descriptive study was performed at George hospital in May 2010 to determine the afterhours case mix and workload. Methods: A total of 2560 patients presented afterhours at the emergency centre for the month of May 2010 that was triaged according to the Cape Triage Score (CTS). The case mix was analyzed according to a pre designed Microsoft Excel data sheet. Results: Three quarters of the case mix were adults and 25% were paediatric cases. Sixty five percent of patients were triaged green, followed by twenty seven percent yellow, five percent orange and two percent red (one percent absconded before doctors evaluation). Besides trauma related cases, respiratory and gastrointestinal problems were the most common presentations. The workload included on average fifty four patients per afterhours weekday, one hundred and thirty eight patients per 24-hour weekend days and one hundred and forty seven for the public holiday. Discussion: This study demonstrated that a significant number of the afterhours case mix presenting at George provincial hospital emergency centre consists of green and yellow level 1 cases which could be more appropriately managed at a level 1 health care facility.
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