PMID- 23250389
OWN - NLM
STAT- MEDLINE
DCOM- 20140224
LR  - 20220408
IS  - 1432-2323 (Electronic)
IS  - 0364-2313 (Linking)
VI  - 37
IP  - 7
DP  - 2013 Jul
TI  - An assessment of the hospital disease burden and the facilities for the 
      in-hospital care of trauma in KwaZulu-Natal, South Africa.
PG  - 1550-61
LID - 10.1007/s00268-012-1889-1 [doi]
AB  - BACKGROUND: Trauma is a significant cause of morbidity and mortality in South 
      Africa. The present study was designed to review the hospital trauma disease 
      burden in light of the facilities available for the care of the injured in 
      KwaZulu-Natal (KZN), South Africa's most populous province. The primary outcomes 
      were the annual hospital burden of trauma in KZN, determined through data 
      extrapolation, and evaluation of the data in light of available hospital 
      facilities within the province of KZN, a developing province. The data were 
      obtained through review of the trauma load in relation to all emergency cases at 
      all levels of hospitals. METHODS: Hospital administrators in KZN were requested 
      to submit trauma caseloads for the months of March and September 2010. Caseloads 
      were reviewed to determine the trauma load for the province per category using 
      two extrapolation methods to determine the predicted range of annual incidence of 
      trauma, intentional versus non-intentional trauma ratios and population-related 
      incidence of trauma. The results were GIS mapped to demonstrate variations across 
      districts. Hospital data were obtained from assessments of structure, process, 
      and personnel undertaken prior to a major sporting event. These were compared to 
      the ideal facilities required for accreditation of trauma care facilities of the 
      Trauma Society of South Africa and other established documents. RESULTS: Data 
      were obtained from 36 of the 47 public hospitals in KZN that manage acute 
      emergency cases. The predicted annual trauma incidence in KZN ranges from 124,000 
      to 125,000, or 12.9 per 1,000 population. This would imply a national public 
      hospital trauma load on the order of at least 750,000 cases per year. Most 
      hospitals are required to treat trauma; however, within KZN many hospitals do not 
      have adequate personnel, medical equipment, or structural integrity to be 
      formally accredited as trauma care facilities in terms of existing criteria. 
      CONCLUSIONS: There is a significant trauma load that consumes vital emergency 
      center resources. Most hospitals will need extensive upgrading to provide 
      appropriate care for trauma. An inclusive trauma system needs to be formalized 
      and funded, especially in light of the planned National Health Insurance for 
      South Africa.
FAU - Hardcastle, Timothy C
AU  - Hardcastle TC
AD  - Department of Surgery (Trauma), Inkosi Albert Luthuli Central Hospital, 
      University of KwaZulu-Natal, PostNet 27, Private Bag X05, Malvern 4055, South 
      Africa. timothyhar@ialch.co.za
FAU - Samuels, Candice
AU  - Samuels C
FAU - Muckart, David J
AU  - Muckart DJ
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PL  - United States
TA  - World J Surg
JT  - World journal of surgery
JID - 7704052
SB  - IM
MH  - *Cost of Illness
MH  - *Developing Countries
MH  - Health Care Surveys
MH  - Health Resources/organization & administration/*statistics & numerical 
      data/supply & distribution
MH  - Health Services Accessibility/organization & administration/statistics & 
      numerical data
MH  - Hospitalization/*statistics & numerical data
MH  - Hospitals, Public/*organization & administration/statistics & numerical 
      data/supply & distribution
MH  - Humans
MH  - Incidence
MH  - Needs Assessment
MH  - South Africa/epidemiology
MH  - Surveys and Questionnaires
MH  - Trauma Centers/*organization & administration/statistics & numerical data/supply 
      & distribution
MH  - Wounds and Injuries/*epidemiology/therapy
EDAT- 2012/12/20 06:00
MHDA- 2014/02/25 06:00
CRDT- 2012/12/20 06:00
PHST- 2012/12/20 06:00 [entrez]
PHST- 2012/12/20 06:00 [pubmed]
PHST- 2014/02/25 06:00 [medline]
AID - 10.1007/s00268-012-1889-1 [doi]
PST - ppublish
SO  - World J Surg. 2013 Jul;37(7):1550-61. doi: 10.1007/s00268-012-1889-1.