Original articles

Acute hospitalisation needs of adults admitted to public facilities in the Cape Town Metro district

E de Vries, P Raubenheimer, B Kies, V C Burch


Introduction. Public health care delivery in South Africa aims to provide equitable access at the most appropriate level of care. We studied to what extent the acute health care needs of adults admitted to public hospitals in the Cape Town Metropole were being appropriately met.
Methods. A retrospective study was conducted of the hospital records of adults admitted to medical beds in public hospitals in Cape Town between August and November 2008. Intensive care unit patients were not included.
Results. Of 802 beds in use, the estimated occupancy was at least 95%. The average time elapsed since admission was 7.9 days; 94.3% of medical admissions were acute; 45% were severely to critically ill on admission; and co-morbid disease was present in 78.1%. Of all admissions, 31.9% were HIV-positive, and 17% had active tuberculosis. At least 396 (51.6%) patients were deemed to have required specialist or subspecialist consultation to expedite appropriate care; 386 (50.3%) accessed the appropriate level of medical care required; 339 (44.2%) accessed a more sophisticated level of care than required; and 42 (5.5%) did not access an adequate level of care. CT scan and ultrasound accounted for 59% of all restricted tests done.
Conclusions. Our findings support the plan to provide more primary care hospital facilities in the metropolitan area. Most patients needing specialised care are accessing such care, and most patients accessing a higher level of care than needed can be addressed by ensuring that they first access primary care and are referred according to protocols.

Authors' affiliations

E de Vries, Family Medicine, UCT and Mitchell's Plain District Hospital

P Raubenheimer, Deprtment of Medicine, UCT

B Kies, Department of Medicine, UCT

V C Burch, Department of Medicine, UCT

Full Text



level of care, point prevalence study, bed occupancy, length of stay, burden of disease

Cite this article

South African Medical Journal 2011;101(10):760-764.

Article History

Date submitted: 2010-10-11
Date published: 2011-09-27

Article Views

Abstract views: 2390
Full text views: 4190

Comments on this article

*Read our policy for posting comments here