Emergency healthcare needs in the Lavender Hill suburb of Cape Town, South Africa: a cross-sectional, community-based household survey

Objective Emergency care is a key component of healthcare systems, but little is known about its real impact on communities. This study evaluated access, utilisation and barriers to healthcare, and specifically emergency care, in the low socioeconomic Cape Town suburb of Lavender Hill.Design A cross...

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Main Authors: Peter W Hodkinson, Jennifer Lee Pigoga, Lee Wallis
Format: Article
Language:English
Published: BMJ Publishing Group 2020-01-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/1/e033643.full
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author Peter W Hodkinson
Jennifer Lee Pigoga
Lee Wallis
author_facet Peter W Hodkinson
Jennifer Lee Pigoga
Lee Wallis
author_sort Peter W Hodkinson
collection DOAJ
description Objective Emergency care is a key component of healthcare systems, but little is known about its real impact on communities. This study evaluated access, utilisation and barriers to healthcare, and specifically emergency care, in the low socioeconomic Cape Town suburb of Lavender Hill.Design A cross-sectional, community-based household survey.Setting Lavender Hill suburb in the Cape Flats of Cape Town, South Africa.Participants Two-stage cluster sampling was used to identify approximately 13 households in each of 46 clusters, for a total of 608 households. A senior householder responded on behalf of each household surveyed.Primary outcome measures Access to, utilisation of and unmet needs related to healthcare at large and emergency care.Results In August 2018, 608 households were surveyed, encompassing 2754 individuals, with a response rate of 96.4%. Almost a quarter of respondents (n=663, 24.1%) used the healthcare system within the last year. Female gender, advancing age, lower levels of education, recipients of disability grants, smaller household sizes and living in formal dwellings were factors associated with increased risk of unmet healthcare and emergency care needs. Only a small proportion of respondents (n=39, 1.4%) reported having unmet emergency healthcare needs, with wait times at facilities (n=9, 23.1%), emergency medical service delays (n=7, 17.9%) and personal safety (n=6, 15.4%) being prominent. There was a high prevalence of chronic medical conditions (hypertension, diabetes and dyslipidaemias) and recent deaths predominantly from trauma and malignancy.Conclusion The emergency healthcare needs of the community appear to be well catered for, although community expectations may not be high and many barriers exist, particularly in accessing emergency care—be it via ambulance services or at healthcare facilities—and caring for chronic diseases in the ageing population. The Lavender Hill community could benefit from programmes addressing chronic disease management and emergency care delivery within the community.
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spelling doaj-art-8dfb73bd45e2486a999036f7ac9d27072025-08-20T02:31:29ZengBMJ Publishing GroupBMJ Open2044-60552020-01-0110110.1136/bmjopen-2019-033643Emergency healthcare needs in the Lavender Hill suburb of Cape Town, South Africa: a cross-sectional, community-based household surveyPeter W Hodkinson0Jennifer Lee Pigoga1Lee Wallis2Division of Emergency Medicine, University of Cape Town, Rondebosch, South AfricaDivision of Emergency Medicine, University of Cape Town, Rondebosch, Western Cape, South AfricaFamily, Community and Emergency Care, University of Cape Town Faculty of Health Sciences, Cape Town, South AfricaObjective Emergency care is a key component of healthcare systems, but little is known about its real impact on communities. This study evaluated access, utilisation and barriers to healthcare, and specifically emergency care, in the low socioeconomic Cape Town suburb of Lavender Hill.Design A cross-sectional, community-based household survey.Setting Lavender Hill suburb in the Cape Flats of Cape Town, South Africa.Participants Two-stage cluster sampling was used to identify approximately 13 households in each of 46 clusters, for a total of 608 households. A senior householder responded on behalf of each household surveyed.Primary outcome measures Access to, utilisation of and unmet needs related to healthcare at large and emergency care.Results In August 2018, 608 households were surveyed, encompassing 2754 individuals, with a response rate of 96.4%. Almost a quarter of respondents (n=663, 24.1%) used the healthcare system within the last year. Female gender, advancing age, lower levels of education, recipients of disability grants, smaller household sizes and living in formal dwellings were factors associated with increased risk of unmet healthcare and emergency care needs. Only a small proportion of respondents (n=39, 1.4%) reported having unmet emergency healthcare needs, with wait times at facilities (n=9, 23.1%), emergency medical service delays (n=7, 17.9%) and personal safety (n=6, 15.4%) being prominent. There was a high prevalence of chronic medical conditions (hypertension, diabetes and dyslipidaemias) and recent deaths predominantly from trauma and malignancy.Conclusion The emergency healthcare needs of the community appear to be well catered for, although community expectations may not be high and many barriers exist, particularly in accessing emergency care—be it via ambulance services or at healthcare facilities—and caring for chronic diseases in the ageing population. The Lavender Hill community could benefit from programmes addressing chronic disease management and emergency care delivery within the community.https://bmjopen.bmj.com/content/10/1/e033643.full
spellingShingle Peter W Hodkinson
Jennifer Lee Pigoga
Lee Wallis
Emergency healthcare needs in the Lavender Hill suburb of Cape Town, South Africa: a cross-sectional, community-based household survey
BMJ Open
title Emergency healthcare needs in the Lavender Hill suburb of Cape Town, South Africa: a cross-sectional, community-based household survey
title_full Emergency healthcare needs in the Lavender Hill suburb of Cape Town, South Africa: a cross-sectional, community-based household survey
title_fullStr Emergency healthcare needs in the Lavender Hill suburb of Cape Town, South Africa: a cross-sectional, community-based household survey
title_full_unstemmed Emergency healthcare needs in the Lavender Hill suburb of Cape Town, South Africa: a cross-sectional, community-based household survey
title_short Emergency healthcare needs in the Lavender Hill suburb of Cape Town, South Africa: a cross-sectional, community-based household survey
title_sort emergency healthcare needs in the lavender hill suburb of cape town south africa a cross sectional community based household survey
url https://bmjopen.bmj.com/content/10/1/e033643.full
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AT leewallis emergencyhealthcareneedsinthelavenderhillsuburbofcapetownsouthafricaacrosssectionalcommunitybasedhouseholdsurvey