A retrospective description of a 12 month caseload at four private emergency centres in South Africa

Master Thesis


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Introduction In South Africa, private emergency departments (ED) are often the first port of call for a substantial proportion of the population served by the private healthcare sector. This study aims to describe the number, acuity and chief complaint of patients that presented to a sample of urban private EDs within South Africa. Methods A retrospective review of patient data from January 2018 to December 2018 was performed for four private facilities from a large private healthcare group. Data collected include demographics, time of arrival, disposal, triage score and presenting complaint. Results A total of 71079 patients presented to the four facilities. The South African Triage Scale (SATS) scores were as follows: red (5%), orange (11%), yellow (65%) and green (19%). Patients arrived mostly during the day (08:00-17:00 (54%)), evening (17:00-22:00 (27%)) and night (22:00-08:00 (19%)). Disposal of patients included admission (14%), discharge (77%), transfer to another facility (2%) and those who left without being seen (3%). The most frequent presenting complaints included gastrointestinal complaints, falls, respiratory issues, fever, traffic accidents and chest pain. Conclusion This study is the first description of the caseload and case mix in private EDs in South Africa. The most common presenting complaints were gastrointestinal and respiratory, with chest pain being the commonest red triaged complaint. Such complaints are similar to international data. In contrast, trauma related to assault is ranked 20th in private as opposed to 1st in the public sector. Admission rates are in keeping with US data, but lower than SA public, UK and Australia. Lastly, many green patients are follow ups which likely relates to the fee-for-service nature of the private sector and continuum of care fulfilled by ED doctors.