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
MAY 2014 / BACKGROUND: One of the key challenges facing the Limpopo Department
of Health and Social Development in the area of Casualty Care is the lack of
trained personnel and the inappropriate referral and utilisation of these
services. There has been no known study conducted in this area in the South
African context and therefore this study was undertaken to evaluate the
services rendered within the Casualty Department at the Polokwane
Mankweng Hospital Complex with specific reference to material and human
resources as well as efficiency of the unit.
AIM: To evaluate the Hospital Casualty Department in the Polokwane
Mankweng Hospital Complex in terms of caseload, influencing factors and
implications on resource utilisation during a one year study period.
METHODOLOGY: A cross sectional study design was employed in this study.
A retrospective record review was done and information was extracted from
various sources of hospital information systems. No primary data was
collected for this study. The setting of this study was the Casualty
Departments at Polokwane Mankweng Hospital Complex. The two hospitals
constituting this complex are situated 30 km apart in Polokwane and Turfloop
respectively. Data was collected on various variables that are relevant to the
functioning of, and resource utilisation in the Casualty Unit of this Complex.
Variables including that of caseload, patient profiles, service costs and
workload on human resources were measured.
RESULTS: This study based on retrospective review of records of 250
patients’ records selected by a simple random sample from a cohort of 14,113
patients who attended the Casualty Department of the Polokwane Mankweng
Hospital Complex during one year study period. One fifth of the patients were
referred from other health facilities and more than 60% of the patients were
discharged after receiving treatment which implied that these patients could
be managed at a regional or district hospital. More patients with medical aid
bypassed the referral system. Almost half of the patients arrived after-hours
(from 18h00 to 6h00).
This is the first study in the Limpopo Province which looked at the direct cost
per patient at the Casualty Department. In 2008/09, overall expenditure was
R 10,321,401.42 (including R 954,168.45 for pharmacy products, other
consumables R 177,261.16 and Laboratory tests R 1,866,233.25). Overall the
Department accounts for an estimated R 7,323,804 in personnel annual
expenditure of the hospital. Unit personnel cost per patient was estimated at
R518.94 (70.96% of total recurrent cost), while the unit costs for the
Pharmaceuticals, Stores and Laboratory tests were; R67.23 (9.24%), R12.56
(1.72%) and R132.24 (18.08%) per patient respectively. Overall the combined
unit cost was estimated at R731.34 per single emergency care patient
excluding the capital costs.
CONCLUSION: The results of the study will be used to guide the allocation of
appropriate resources, and to highlight the need to implement an effective
referral system, which will assist in reducing the workload.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/15517 |
| Date | January 2014 |
| Creators | Mohapi, Morongwa Caroline |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf |
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