The after-hours case mix of patients attending the George Provincial Hospital Emergency Centre

Abstract

Background: The emergency care of patients in South Africa has improved with the establishment of Emergency and Family Medicine as specialities, the introduction of the Cape Triage Scoring (CTS), and the upgrading of emergency care services. The Western Cape Comprehensive Service Plan stipulates that 90% of care should be delivered through primary and district (level 1) services, 8% through general specialist (level 2) services and 2% through super-specialist (level 3) services. Many patients needing level 1 care present after hours at level 2 facilities. This study was undertaken to determine the after-hours emergency centre case mix and workload at George Provincial Hospital Emergency Centre. Method: This was a descriptive retrospective study. Using the CTS, emergency centre staff triaged 2 560 patients who presented for care after hours in May 2010. The data were entered and analysed in MS Excel^®. The case mix and workload were then determined. Results: Adults comprised 75% of the case mix. Sixty-five per cent of patients had routine (CTS “green”) complaints, 27% had urgent (CTS “yellow”) complaints, 5% had very urgent complaints (CTS “orange”) and 2% needed immediate care (CTS “red”). Trauma, respiratory and gastrointestinal problems were the most common presentations. The workload during the study period from 1–31 May 2010 included 54 patients after hours on weekdays, 138 patients per 24-hour (08h00-08h00) weekend days and 147 on public holidays. Conclusion: This study showed that 47% of patients who presented after hours at the George Provincial Hospital Emergency Centre required primary or level 1 care. These patients could be more appropriately managed at a level 1 facility.