A research report submitted to the Faculty of Health Sciences,
University of the Witwatersrand, in partial fulfilment of the
requirements for the degree of Master of Public Health in the field of
Hospital Management
Johannesburg, 2011 / Introduction: South Africa is currently facing a quadruple burden of diseases:
poverty related conditions, emerging chronic diseases, injuries and HIV/AIDS.
Increasing burden of these diseases is having a detrimental impact on service
delivery particularly in rural areas, where the majority of the population are
dependent on public health system. Although numerous epidemiological studies
had been done in the past to determine the prevalence of these conditions, only
a few studies have attempted to quantify the effect of these diseases on health
facilities such as admission rate, bed occupancy rate and resource utilisation.
More data is required to develop a better understanding of their impact and to
guide development of appropriate response strategies.
Aim of the study: To `analyse trends of admissions and resource utilisation in
adult medical wards of a rural district hospital in South Africa.
Methodology: This was a descriptive cross-sectional, retrospective study
involving an analysis of data from adult medical wards in the George Masebe
Hospital (a district hospital in Limpopo Province) for six months in 2009.
Results: The study found average number of admissions per month was 148,
their length of stay varied from one day to more than a year. Their median age
was 44 years. They were black, had no medical aid and unemployed and the
majority of them were dependent on social welfare grant. The most common
health problems diagnosed amongst the medical admissions were HIV related
conditions such as gastro-enteritis, pneumonia, AIDS and tuberculosis as well as
other chronic diseases such as diabetes mellitus. A striking discovery was the
high incidence of mental illness amongst the admissions. The majority of them
were discharged home. The crude death rate was 190 per 1000 admissions and
the main cause of death was HIV related conditions. The average direct
expenditure per month was R 1,040,579. The expenditure for salaries was the
main expenditure (54%) followed by Allied health services (29%). The average
expenditure per patient was R 7,039 (R 7,548 for female patients and R 6454 for
male patients).
v
Conclusion: This was the first study on admission trends resource utilisation in
this Hospital and in the Limpopo Province. The evidence from this study would
hopefully steer the re-organisation of some of the Hospital services, more
especially the establishment of a step-down ward facility within the Hospital. This
study has recognised that the increased number of admissions in rural district
hospitals often result from double burden of infectious and chronic diseases.
More studies on the subject are needed to identify their impact on resource
utilisation at these hospitals.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/13669 |
| Date | January 2011 |
| Creators | Mautjana, Maria Ntana |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf, application/pdf, application/pdf |
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