title: Bed use in the medical wards of Red Cross War Memorial Children's Hospital, Cape Town.
abstract: OBJECTIVE
  To determine extent of appropriate (medically necessary) and inappropriate bed use and level of care (LOC) needed by patients admitted to hospital.
  
  
  METHODS
  A cross-sectional, descriptive survey.
  
  
  METHODS
  Medical wards of Red Cross War Memorial Children's Hospital (RCCH), a teaching hospital of the University of Cape Town.
  
  
  RESULTS
  A 25% sample of beds was selected randomly each day for 12 consecutive days during September-October 1990. Data were collected using a questionnaire based on the Pediatric Appropriateness Evaluation Protocol and the Delay Tool. A subjective measure of LOC was developed. Questionnaires were completed for 171 admissions and 365 patient days; 98% of admissions and 79.5% of patient days were medically justified, and 49% of admissions needed tertiary care. The remaining 51% could have been treated by general paediatricians (17%) or medical officers (32%) in community hospitals. Of delays (unnecessary patient days) 62% were hospital-related, 20% were family-related and 18% were related to inadequate lower level institutional care and outpatient services.
  
  
  CONCLUSIONS
  RCCH is functioning as a general, specialist and super-specialist hospital. Its future role as a tertiary referral centre will depend on adequate provision of community-based care. Further cost-benefit research is needed to address areas of inappropriate bed use identified in this study.
authors.affiliation: Department of Paediatrics and Child Health, University of Cape Town.
authors.forename: L
authors.initials: L
authors.lastname: Henley
authors.forename: M
authors.initials: M
authors.lastname: Smit
authors.forename: P
authors.initials: P
authors.lastname: Roux
authors.forename: M
authors.initials: M
authors.lastname: Zwarenstein
mesh_terms: D001509:Bed Occupancy / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003710:Demography; D006760:Hospitalization / Q000706:statistics & numerical data; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010348:Patient Care Team; D013019:South Africa