PMID- 32657720
OWN - NLM
STAT- MEDLINE
DCOM- 20200803
LR  - 20200803
IS  - 2078-5135 (Electronic)
VI  - 110
IP  - 5
DP  - 2020 Apr 29
TI  - Bellwether operations in KwaZulu-Natal Province, South Africa, are performed at 
      regional and tertiary rather than district hospitals.
PG  - 374-376
LID - 10.7196/SAMJ.2020.v110i5.14218 [doi]
AB  - BACKGROUND: Previous work from KwaZulu-Natal (KZN) Province, South Africa, has 
      suggested that public sector district hospitals are not providing adequate access 
      to surgical care in the form of bellwether operations (caesarean section (CS), 
      open reduction of fractures (ORF) and laparotomy). OBJECTIVES: To review the 
      surgical output of regional and tertiary institutions, to quantify their 
      contribution to providing bellwether procedure coverage for the province. 
      METHODS: Data on bellwether operations conducted at all district, regional, 
      tertiary and central hospitals in the public health sector of KZN for the period 
      1 July - 31 December 2015 were collected from operating theatre registers. 
      RESULTS: Between 1 July and 31 December 2015, a total of 20 926 CSs, 3 947 
      laparotomies and 3 098 ORFs were performed in KZN provincial hospitals. This 
      translates to a provincial rate for each bellwether procedure of 192/100 000 
      (CS), 36/100 000 (laparotomy) and 28/100 000 (ORF). The rate of  bellwether 
      operations across the province during the study period was 256/100 000, with 
      numbers as follows: CSs - 10 542 in district hospitals, 8 712 in regional 
      hospitals, 1 538 in tertiary hospitals and 134 in the central hospital; 
      laparotomies - 235 in district hospitals, 2 314 in regional hospitals, 1 259 in 
      tertiary hospitals and 139 in the central hospital; and ORFs - 196 in district 
      hospitals, 1 660 in regional hospitals, 1 201 in tertiary hospitals and 41 in the 
      central hospital. CONCLUSIONS: Regional and tertiary hospitals are performing the 
      bulk of non-obstetric bellwether operations in KZN. This imbalance has major 
      implications for planning future delivery of surgical care in the province.
FAU - Tefera, A
AU  - Tefera A
AD  - Epidemiology Unit, KwaZulu-Natal Department of Health, Pietermaritzburg, South 
      Africa. aida.tefera@kznhealth.gov.za.
FAU - Lutge, E
AU  - Lutge E
FAU - Clarke, D L
AU  - Clarke DL
LA  - eng
PT  - Journal Article
DEP - 20200429
PL  - South Africa
TA  - S Afr Med J
JT  - South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
JID - 0404520
SB  - IM
MH  - Cesarean Section/*statistics & numerical data
MH  - Female
MH  - Fractures, Bone/therapy
MH  - Health Services Accessibility/statistics & numerical data
MH  - Hospitals, District/statistics & numerical data
MH  - Humans
MH  - Laparotomy/*statistics & numerical data
MH  - Open Fracture Reduction/*statistics & numerical data
MH  - Pregnancy
MH  - Regional Medical Programs/*statistics & numerical data
MH  - South Africa
MH  - Tertiary Care Centers/*statistics & numerical data
EDAT- 2020/07/14 06:00
MHDA- 2020/08/04 06:00
CRDT- 2020/07/14 06:00
PHST- 2020/04/29 00:00 [received]
PHST- 2020/07/14 06:00 [entrez]
PHST- 2020/07/14 06:00 [pubmed]
PHST- 2020/08/04 06:00 [medline]
AID - 10.7196/SAMJ.2020.v110i5.14218 [doi]
PST - epublish
SO  - S Afr Med J. 2020 Apr 29;110(5):374-376. doi: 10.7196/SAMJ.2020.v110i5.14218.