Audit of surgical specialty patients and beds at Pietersburg Hospital, Limpopo Province, South Africa in 2021

Abstract

Hospital beds are in great demand all over the world. [1] Hospital beds are expensive; in South Africa (SA), the ballpark figure per bed per year is ZAR1 million for secondary hospitals and ZAR2 million per year for academic hospitals. Hospital managers are therefore generally pressurised to keep the total number of beds as low as possible. Although the absolute number of beds is usually discussed, the precise utilisation of the beds is often neglected. This is a huge oversight if patients are kept unnecessarily admitted, and drives the costs enormously. There are obvious competing demands for beds by the non-cutting and cutting (surgical) specialties, and decisions around this are typically political and philosophical.According to the World Health Organization, ~2 billion people around the world are estimated to have inadequate access to surgical care. [2] Surgical care is an integral part of health systems worldwide. However, delays due to multiple transfers of surgical patients are common, even in developed countries. [3][4][5] Pietersburg Hospital (PH) is a teaching hospital for the University of Limpopo, which is 31.5 km east of Polokwane city, the provincial capital. The hospital serves as the referral hospital for regional and district hospitals in the province. The hospital has 196 beds set aside for all adult surgical patients. Most of the beds (128) are reserved for male patients, while female patients have 68 beds. Various surgical specialties are responsible for bed allocation.The audit reported in the present study is the first to describe the actual surgical specialty bed utilisation and the average length of stay (LoS) at a tertiary hospital in Limpopo Province, SA. In this hospital, patients are allocated to wards where beds are available, even if it is not the correct unit under which the patient should receive treatment. In an ideal situation, patients should be followed up and transferred to the correct ward as soon as a bed becomes available. If not, beds are unnecessarily occupied and this creates delay for those patients still awaiting hospital care and clinical procedures. [6] Patients are often denied acute surgical management due to unavailability of beds. This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.