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
OCTOBER 2014 / BACKGROUND: Gelukspan District Hospital is situated in the Ngaka Modiri
Molema District in the North West Province. The majority of patients admitted
in the adult medical wards of this Hospital are due to two conditions namely
(a) HIV/ AIDS and (b) Cardio-metabolic diseases. The Hospital regularly
analyse data related to the HIV/ AIDS patients for HIV/ AIDS conditional grant.
The information related to cardio-metabolic diseases are seldom analysed by
the Hospital management, although there is a belief within the Hospital that
more than one thirds of the patients admitted in these two wards are due to
cardio–metabolic diseases. This study was planned against this background
to systematically analyse the routinely collected data from the Hospital
information system. The results of the study would hopefully provide the
estimation of the prevalence of these diseases at a health facility level and the
cost for managing these conditions.
AIM: To describe the profiles of patients admitted of cardio–metabolic
diseases in the Gelukspan District Hospital in the North West Province during
one year study period (from 01 April 2010 to 31 March 2011).
METHODOLOGY: This was a cross-sectional study based on retrospective
review of routinely collected data from the Adult Medical Wards of the
Gelukspan District Hospital during the one year study period (1 April 2010 to
31 March 2011). No primary data was collected for this study. The study
variables included: the number of subjects with cardio-metabolic diseases
among the subjects who were admitted in the Medical wards of the Hospital
during one year study period; their profiles and the type and cost of laboratory
tests performed for these patients at the time of admission. Permission to
conduct the research at the Hospital was obtained from the North West
Department of the Health and the University of the Witwatersrand ‘Human
Research Ethics Committee (Medical) before commencement of the study.
RESULTS: Number of admissions in male and female medical wards for noncommunicable
diseases was 558. There were almost same number of female
(n= 287) and male (271) admissions. The result showed that both males and
females suffer equally from cardio-metabolic diseases. The age – group
8805634J DM Moalosi
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analysis showed almost a third of the subjects were below 50 years age and
another third was above 65 years of age. More than 20% of the population
were pensioners representing the age distribution of the study cohort. The
majority of the subjects were black (97.8%) and unemployed (98%)
representing the demographics of the catchment population. The majority of
the women were single (55.4%). There was no significant difference between
male and female patients in terms of primary clinical diagnoses. Thirty-nine
percent of the males (n=108) and 56% (163) females stayed more than 3
days (the norms of average length of stay for District hospitals. The case
fatality rate was 19.5% probably high in a district hospital setting, this implies
that probably these patients were not managed properly at the PHC level and
or at this The laboratory tests done at the time of admission included random
and fasting blood glucose, and creatinine. No HbA1C, lipogram and other
renal function tests were done at the time of admission contrary to the norms
and guidelines for management of cardio-metabolic diseases. The laboratory
test result showed the possibility of significant comorbidity among the patients.
Fourteen percent of the subject probably had nephropathy.
CONCLUSION: This was the first study conducted in this Hospital to
systematically evaluate management of a particular group of patients.
Hopefully, this study would assist the Hospital management to improve the
management of patients admitted in this Hospital.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/17330 |
| Date | 10 1900 |
| Creators | Moalosi, Derrick Meriting |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf |
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