Analysing acuity of after-hours attendees at a district hospital emergency centre in KwaZulu-Natal

Abstract

Introduction: Little is known about the after-hours utilisation of rural hospital emergency centres (EC) in South Africa. The aim of this study was to determine the proportion of patients consulted after-hours at GJ Crookes Hospital (GJC) EC that required emergent or urgent treatment. Associations with age, gender and mode of transport were also investigated. Methods: A four week prospective analysis was conducted after-hours at the GJC EC and patient acuity was assessed based on the South African Triage Scale (SATS). Results: The majority of patients attending the EC at GJC after-hours were classified as green code (59.7%). Within all age groups, the largest group of patients was green code. Within the oldest age group (>65 years) there were significantly more orange code patients. Although no association was demonstrated between transport mode and after-hours attendance, 59.5% (N = 393) of patients brought by Emergency Medical and Rescue Services (EMRS) were triaged as green code on arrival. 66.2% of cases brought by EMRS were deemed not to require urgent attention by the attending doctors. Discussion: The data from this study demonstrate that the GJC EC is utilised inappropriately after-hours. The majority of patients could be treated at a clinic level. This has direct implications for the provision of emergency care and utilisation of already strained resources in our hospitals.

Keywords

• After-hours acuity
• Triage
• ED overcrowding
• EMS transport of patients