A burden on the health system

2019-02-26 06:01
Professor Andrew Nicol, Dr Nomafrench Mbombo, Professor Lorna Martin and Dr Shaheem de Vries briefed the media on the effects of violence and alcohol on the health system.

Professor Andrew Nicol, Dr Nomafrench Mbombo, Professor Lorna Martin and Dr Shaheem de Vries briefed the media on the effects of violence and alcohol on the health system.

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The Western Cape provincial health department has explained the impact violence and alcohol has on the health system and why there is sometimes a delay in attending to emergency cases.

In a media briefing held at Groote Schuur Hospital on Tuesday 19 February, MEC for helath Dr Nomafrench Mbobo said the festive season posed a number of challenges to the health system.

“Numerous crashes kept our Emergency Medical and Forensic Pathology Services very busy while staff at our emergency centres had to bear the brunt of an additional, yet avoidable, burden of injury-related cases fuelled by violence and alcohol abuse,” Mbobo said.

Mbobo further said that the average waiting time for patients visiting Tygerberg and Groote Schuur hospitals is about four hours.“This is caused by the number of people who visit our premises daily. Also, because we (Groote Schuur Hospital) are the biggest hospital in the country, we often get patients from all over the country and beyond.Some patients get referred by general practitioners to us. That also causes a backlog of cases being attended to,” she said.

She added that the hospital works on a Patient Unique Identifier, whereby they are piloting a system that might reduce the time for looking for patient files and waiting periods.

Director of Emergency Services, Dr Shaheem de Vries, said attacks on Emergency Medical Services personnel are not because they are a target. He said we live in a violent society, so paramedics are not necessarily a target.

“When we look at our survey of the staff, 70% of our staff are exposed to violence outside the workplace. That is one of the key issues [where] we link violence within the health system. We talk about how we should support staff members who are exposed to crime.I am surprised that the system has not collapsed because we have 30 000 people who come to work every day.”

He said there are plans to deal with this issue.

Head of the Division of Forensic Medicine and Toxicology at UCT, Professor Lorna Martin, said the number of unnatural deaths in the Western Cape has gone up from 8 000 to 11 000 in the past five years, resulting in a backlog in forensic pathology.

“The burden has increased dramatically without the increase in capacity and resources to deal with that, and it is because the violence and cases are increasing. We are struggling,” she said.

The stats for 15 December to 15 January:

.More than 30 000 emergency cases were transported to hospitals by EMS personnel. Of these cases, 8069 were as a result of patients suffering injuries from violence and accidents. Of the 8069 cases, 2894 of the patients had been assaulted with some sort of weapon. Physical assault caused 956 cases and accidental injuries totalled 864. EMS facilitated over 14 000 inter-facility transfers. Of these, 1481 related to all forms of injuries whereas a staggering 1131 cases were as a direct result of violence.

.Over 11 000 mortuary cases were admitted across the Western Cape in 2018. The impact of the high number of deaths due to unnatural causes has resulted in a backlog and an increase in caseloads at mortuaries. In the Metro alone, the health department received over 8000 admissions at their two large state mortuaries in Tygerberg and Salt River – 4400 of these cases were at Tygerberg and 4037 at the Salt River mortuary.

.The estimated cost of the admission and treatment of patients with gunshot injuries is approximately R22 000 per patient and should the patient also require orthopaedic surgery, R25 000 more will be required. The figures do not include ambulance transport costs, treatment received in an emergency centre, or either rehabilitation cost or forensic pathology.

The Western Cape provincial health department has explained the impact violence and alcohol has on the health system and why there is sometimes a delay in attending to emergency cases.

In a media briefing held at Groote Schuur Hospital on Tuesday 19 February, MEC for helath Dr Nomafrench Mbobo said the festive season posed a number of challenges to the health system.

“Numerous crashes kept our Emergency Medical and Forensic Pathology Services very busy while staff at our emergency centres had to bear the brunt of an additional, yet avoidable, burden of injury-related cases fuelled by violence and alcohol abuse,” Mbobo said. Mbobo further said that the average waiting time for patients visiting Tygerberg and Groote Schuur hospitals is about four hours.“This is caused by the number of people who visit our premises daily. Also, because we (Groote Schuur Hospital) are the biggest hospital in the country, we often get patients from all over the country and beyond.Some patients get referred by general practitioners to us. That also causes a backlog of cases being attended to,” she said.

She added that the hospital works on a Patient Unique Identifier, whereby they are piloting a system that might reduce the time for looking for patient files and waiting periods.

Director of Emergency Services, Dr Shaheem de Vries, said attacks on Emergency Medical Services personnel are not because they are a target. He said we live in a violent society, so paramedics are not necessarily a target.

“When we look at our survey of the staff, 70% of our staff are exposed to violence outside the workplace. That is one of the key issues [where] we link violence within the health system. We talk about how we should support staff members who are exposed to crime.I am surprised that the system has not collapsed because we have 30 000 people who come to work every day.”

He said there are plans to deal with this issue.

Head of the Division of Forensic Medicine and Toxicology at UCT, Professor Lorna Martin, said the number of unnatural deaths in the Western Cape has gone up from 8 000 to 11 000 in the past five years, resulting in a backlog in forensic pathology.

“The burden has increased dramatically without the increase in capacity and resources to deal with that, and it is because the violence and cases are increasing. We are struggling,” she said.

The stats for 15 December to 15 January:

.More than 30 000 emergency cases were transported to hospitals by EMS personnel. Of these cases, 8069 were as a result of patients suffering injuries from violence and accidents. Of the 8069 cases, 2894 of the patients had been assaulted with some sort of weapon. Physical assault caused 956 cases and accidental injuries totalled 864. EMS facilitated over 14 000 inter-facility transfers. Of these, 1481 related to all forms of injuries whereas a staggering 1131 cases were as a direct result of violence.

.Over 11 000 mortuary cases were admitted across the Western Cape in 2018. The impact of the high number of deaths due to unnatural causes has resulted in a backlog and an increase in caseloads at mortuaries. In the Metro alone, the health department received over 8000 admissions at their two large state mortuaries in Tygerberg and Salt River – 4400 of these cases were at Tygerberg and 4037 at the Salt River mortuary.

.The estimated cost of the admission and treatment of patients with gunshot injuries is approximately R22 000 per patient and should the patient also require orthopaedic surgery, R25 000 more will be required. The figures do not include ambulance transport costs, treatment received in an emergency centre, or either rehabilitation cost or forensic pathology.

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