National audit of critical care resources in South Africa - unit and bed distribution.
OBJECTIVE
To determine the national distribution of intensive care unit (ICU)/high care (HC) units and beds.


METHODS
A descriptive, non-interventive, observational study design was used. An audit of all public and private sector ICU and high care units in South Africa was undertaken.


RESULTS
A 100% sample was obtained; 23% of public and 84% of private hospitals have ICU/HC units. This translates to 1,783 public and 2,385 private beds. Only 18% of all beds were HC beds. The majority of units and beds (public and private) were located in three provinces: Gauteng, KwaZulu-Natal and the Western Cape. The Eastern Cape and Free State had less than 300 beds per province; the remaining four provinces had 100 or fewer beds per province. The public sector bed: population ratio in the Free State, Gauteng and Western Cape was less than 1:20,000. In the other provinces, the ratio ranged from 1:30,000 to 1:80,000. The majority of units are in level 3 hospitals. The ICU bed: total hospital bed ratio is 1.7% in the public sector compared with 8.9% in the private sector. The ratio is more when the comparison is made only in those hospitals that have ICU beds (3.9% v. 9.6% respectively). In the public and private sector 19.6% beds are dedicated to paediatric and neonatal patients with a similar disparity across all provinces. Most hospitals admit children to mixed medical surgical units. Of all ICU beds across all provinces 2.3% are commissioned but not being utilised.


CONCLUSIONS
The most compelling conclusion from this study is the need for regionalisation of ICU services in SA.
Bhagwanjee
Sats
S
Department of Anaesthesiology, University of the Witwatersrand and Johannesburg Hospital, Johannesburg, South Africa. satish.bhagwanjee@wits.ac.za
Scribante
Juan
J
D054869:Clinical Audit / Q000379:methods; D003422:Critical Care / Q000706:statistics & numerical data*; D006742:Hospital Bed Capacity / Q000706:statistics & numerical data*; D016304:Hospitals, Private / Q000145:classification / Q000706:statistics & numerical data*; D006779:Hospitals, Public / Q000145:classification / Q000706:statistics & numerical data*; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D013019:South Africa; D011795:Surveys and Questionnaires