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.
Design and setting. 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
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.
Conclusion. The most compelling conclusion from this study is the need for regionalisation of ICU services in SA.
South African Medical Journal Vol. 97 (12) 2007: pp. 1311-1314