A point-prevalence survey of public hospital inpatients with palliative care needs in Cape Town, South Africa

Abstract

Objectives. To assess the need for palliative care among inpatients occupying acute beds in the public sector hospitals of the Cape Town metropole.

Methods. A cross-sectional, contemporaneous, point-prevalence study was performed at 11 public sector hospitals in the Cape Town metropole using a standardised palliative care identification tool. Data were collected on the socio-demographic characteristics, diagnoses, and prior and current care planning of patients.

Results. The case notes of 1 443 hospital inpatients were surveyed, and 16.6% were found to have an active life-limiting disease. The mean age of the group was 56 years. The diagnoses were cancer in 50.8%, organ failure in 32.5%, and HIV/tuberculosis in 9.6%. The greatest burden of disease was in the general medical wards, to which an overall 54.8% of patients meeting the requirements for palliative care were admitted.

Conclusions. This study provides evidence for the need for palliative care services in public sector hospitals and in the health system as a whole. The young age of patients and the high prevalences of end-stage renal failure and HIV are unique, and the burden in the general medical wards suggests a focus for initial inpatient programmes.