Referral of District Level Operations to Regional Hospitals in South Africa.
J Surg Res
; 278: 149-154, 2022 10.
Article
em En
| MEDLINE
| ID: mdl-35598498
ABSTRACT
INTRODUCTION:
In South Africa, district hospitals have limited surgical capacity, and most surgical conditions are referred to higher-level facilities for definitive management. This study aims to identify the proportion, type, and volume of district-level general surgery referrals to two regional government hospitals in South Africa. MATERIALS ANDMETHODS:
This was a retrospective analysis of secondary data collected on persons who underwent general surgery operations at two South African regional hospitals between January 1, 2016 and December 31, 2018. District-level operations were those included in the South African Department of Health District Health Package. Descriptive analyses were performed to determine the proportions of district-level general surgery referrals and operations. Multivariate analyses were performed to determine factors associated with district-level general surgery operations.RESULTS:
A total of 9357 persons underwent general surgery operations. Of these, 5925 (63.3%) were district-level operations. The most common district-level operations were lower limb amputations (n = 1007; 17.0%), abscess drainage (n = 936; 15.8 %), appendectomy (n = 791; 13.4%), non-trauma emergency laparotomy (n = 666; 11.2%), and inguinal hernia repair (n = 574; 9.7%). In multivariate analysis, district-level operations were associated with emergency conditions (OR 5.64, P < 0.001), trauma (OR 1.43, P < 0.001) and male gender (OR 2.35, P < 0.001).CONCLUSIONS:
In South Africa, the majority of general surgery diseases treated at regional hospitals are district-level conditions. The definition of district-level conditions could be too broad, and a narrower basket of surgical care for district hospitals would focus training efforts on achievable targets. More resources are needed at regional hospitals to care for their additional surgical burden.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Encaminhamento e Consulta
/
Hospitais de Distrito
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article