Bed utilisation trends in selected wards across eight district hospitals in the Cape Town district

Master of Public Health - MPHBackground: The largest focus areas for the department of health is ensuring access to quality healthcare. The district health system (DHS) model remains the vehicle used by the district managers to deliver on the health department’s goals, objectives and priority focus areas. Strengthening the district health system platform is therefore important to the department to improve access and quality of care to the clients serviced in the province. The district hospitals play a fundamental role since they support primary health care (PHC) and serve as the entry point to more specialised care. The efficient management of beds in the district hospitals is the key in ensuring access to care and preventing bed blocking. Bed Utilisation Rate (BUR) and Average Length of Stay (ALOS) are indicators used to measure the efficiency of hospital beds. This study provides a description of the trends in bed utilisation within the inpatient wards of eight district hospitals in the Cape Town metro district in the 2016-2017 financial period. Methodology: To analyse and compare wards a quantitative approach was used. Inpatient ward activity reports for eight district hospitals were accessed from the department of health’s routine data collection repository. A total of fifty-five wards were compared across small and large hospitals for BUR and ALOS during the financial year period 1 April 2016 to 31 March 2017. Data entry was done in MS EXCEL and analyses were done using STATA 11.0

Risk factors for Coronavirus disease 2019 (Covid-19) death in a population cohort study from the Western Cape province, South Africa

Risk factors for coronavirus disease 2019 (COVID-19) death in sub-Saharan Africa and the effects of human immunodeficiency virus (HIV) and tuberculosis on COVID-19 outcomes are unknown. We conducted a population cohort study using linked data from adults attending public-sector health facilities in the Western Cape, South Africa. We used Cox proportional hazards models, adjusted for age, sex, location, and comorbidities, to examine the associations between HIV, tuberculosis, and COVID-19 death from 1 March to 9 June 2020 among (1) public-sector “active patients” (≥1 visit in the 3 years before March 2020); (2) laboratory-diagnosed COVID-19 cases; and (3) hospitalized COVID-19 cases. We calculated the standardized mortality ratio (SMR) for COVID-19, comparing adults living with and without HIV using modeled population estimates.Among 3 460 932 patients (16% living with HIV), 22 308 were diagnosed with COVID-19, of whom 625 died. COVID19 death was associated with male sex, increasing age, diabetes, hypertension, and chronic kidney disease. HIV was associated with COVID-19 mortality (adjusted hazard ratio [aHR], 2.14; 95% confidence interval [CI], 1.70–2.70), with similar risks across strata of viral loads and immunosuppression. Current and previous diagnoses of tuberculosis were associated with COVID-19 death (aHR, 2.70 [95% CI, 1.81–4.04] and 1.51 [95% CI, 1.18–1.93], respectively). The SMR for COVID-19 death associated with HIV was 2.39 (95% CI, 1.96–2.86); population attributable fraction 8.5% (95% CI, 6.1–11.1)