Negotiating the new health care system in Cape Town, South Africa: five case studies of the acutely chronically ill.
This article examines the experiences of chronically ill disadvantaged patients in a newly reformed health care system against a backdrop of inequalities still prevalent in the wider postapartheid sociopolitical economy of the Western Cape, South Africa. Patients negotiated a hierarchy of spaces at the national level of transformation and policy and at community-, secondary-, and tertiary-level facilities. The institutionalization of patients meant that expensive medical treatment was mobilized in accordance with different stages of illness and that certain services were available only to "qualifying" categories of diagnoses.
Gibson
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Department of Anthropology and Sociology, University of the Western Cape. dgibson@uwc.ac.za
D000208:Acute Disease; D000328:Adult; D000552:Ambulances; D002908:Chronic Disease / Q000628:therapy*; D003695:Delivery of Health Care / Q000145:classification / Q000191:economics / Q000458:organization & administration* / Q000592:standards; D004630:Emergencies; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration*; D019456:Health Transition; D017052:Hospital Mortality; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011057:Politics; D011787:Quality of Health Care; D012959:Socioeconomic Factors; D013019:South Africa; D014850:Waiting Lists