Geographical maldistribution of surgical resources in South Africa: A review of the number of hospitals, hospital beds and surgical beds.
The full extent of the global burden of surgical disease is to a large extent unknown. It has been estimated that > 2 billion people worldwide do not have access to the most basic surgical care.  Clearly, the 'unmet surgical need' is enormous. The Lancet Commission on Global Surgery (LCGS) acknowledged that surgery should be included as a core component of any health system, and made recommendations to stakeholders with regard to funding, provision and governance of surgical care. The LCGS designed a template to be used by stakeholders when implementing a national surgical plan, and included recommendations on infrastructure (tracking the number and distribution of facilities), workforce (density and distribution of surgical, anaesthetic and obstetric specialists), service delivery (Bellwether procedures), financing and information management (robust information systems). 
A major contributing factor to the global crisis with regard to surgery is the lack of comprehensive data, with few studies investigating surgical infrastructure and resources. The problem is further compounded by the lack of clarity as to which metrics should be measured to assess surgical infrastructure and resources. Furthermore, many of the metrics currently available have limitations when used to assess surgical services.
The development of a surgical plan requires an analysis of the existing surgical facilities. Therefore, the aim of the current study was to analyse the number of surgical beds in each province in South Africa (SA) relative to the overall number of health facilities, i.e. the number of hospitals and hospital beds.
Study design and data collection
This study was a descriptive analysis of the overall number of hospitals, hospital beds and surgical beds in SA. SA has a dual health service, i.e. a public health service funded by the state and a private health service for patients who have health insurance or are self funded. The latter is used by ~16% of the population. Public hospitals were categorised as district-, regional- and tertiary-level hospitals according to the National Department of Health (NDoH) criteria.  According to NDoH definitions, district hospitals are staffed by family physicians or medical officers, regional hospitals are staffed by general specialists, and tertiary hospitals are staffed by general specialists and/or sub-specialists. However, there is considerable overlap, e.g. a district-level hospital may have specialists on the staff and provide specialist level of care. Clinics and so-called specialised hospitals, such as psychiatric, tuberculosis and rehabilitation facilities, were excluded, based on the assumption that limited or no surgery occurred at these facilities. Private facilities that performed day theatre surgery were included.
A list of all hospitals in SA was obtained from the Provincial DoH and cross-referenced with electronic databases of hospitals in SA (Medpages and hospital websites). These were cross-referenced with the NDoH hospital list from the office of the minister of health.
The Health Systems Trust provided estimates of the total number of hospitals and hospital beds for each province for comparison among the provinces. The public hospitals were grouped according to the nine provinces in SA and were subdivided into major district municipalities.
All hospitals were contacted telephonically and by email. Either the chief executive officer, superintendent or matron (in the case of district-level facility) in each hospital was contacted to obtain the relevant data. Data were collected from 1 October to 31 December 2014. Private hospital data were readily available from the Hospital Association of SA (HASA) and included extensive data on the number of hospitals, total number of hospital beds and type of beds. Private hospitals were contacted telephonically to verify these data.
Permission to conduct this research was obtained from the provincial departments of health and from the individual hospitals. The research was approved by the Human Research and Ethics Committee, University of Cape Town (ref. no. HREC 515/2013, 515/2014, 515/2015) and the departmental Research Committee for the Department of Surgery, University of Cape Town.
South African background
Population estimates for 2014 were obtained from census data from Stats SA.  In 2014, SA had a population of 54 million.  The World Bank has designated SA as an upper-middle-income country, with a gross domestic product (GDP) of USD6 619 per capita. The total GDP for 2014 was USD350 billion, with an estimated growth rate of 1.5%.  SA has been divided into nine provinces: the Eastern Cape (EC), the Free State (FS), Gauteng Province (GP), KwaZulu-Natal (KZN), Limpopo Province (LP), Mpumalanga Province (MP), North West (NW), the Northern Cape (NC) and the Western Cape (WC). These have been subdivided into 52 district municipalities. 
The total number of hospitals and public and private hospitals in each province were documented. Similarly, the total number of hospital beds and surgical beds in the public and private sector in each province were documented. Using the population estimates for 2014, the number of hospitals and hospital/ surgical beds per 100 000 population were calculated. Based on the estimation that 16% of the population have medical insurance and make use of the private sector,  the number of public hospitals and beds per 100 000 uninsured population and the number of private hospitals and beds per 100 000 insured population in each province were calculated.
Total number of hospitals
A total of 544 hospitals were included in the study, of which 217 were private hospitals and 327 public hospitals. The provincial distribution of both private and public hospitals is shown in Fig. 1. The largest total number of hospitals was in GP (n=111) and the smallest in NC (n = 21).
Of the 327 public hospitals, 257 (79%) were district-level hospitals, 49 (15%) were regional-level hospitals and 21 (6%) were tertiary-level hospitals. The majority of public hospitals were in EC (n=75), although most of these were district-level hospitals. These were followed by KZN (n=54), WC (n=40), LP (n=37) and FS (n=30). The fewest public hospitals were in NW (n=20) and NC (n=17). There were no tertiary-level hospitals in NC and NW, with only 1 in FS. KZN (n=14) and GP (n=11) had the largest number of regional hospitals (Table 1).
The largest number of private hospitals were located in GP (n=85), followed by WC (n=34) and KZN (n=31) (Table 1).
Hospitals per 100 000 population
Hospitals per 100 000 population were calculated for the total number of hospitals, although accessibility to private hospitals is limited to ~16% of the population as part of the current health scheme in SA (Table 1). 
The largest total number of hospitals per population were in NC (1.79/100 000), FS (1.65/100 000) and EC (1.31/100 000). These provinces were regarded as being less well resourced. A comparison of public hospitals per 100 000 uninsured population (84% of SA) and private hospitals per 100 000 insured population (16% of SA) is shown in Table 2.
These results provide a more meaningful perspective. There were more private hospitals per insured population compared with public hospitals per uninsured population in all the provinces. The difference was greatest in FS and GP, and smallest in EC, LP and MP. GP had the fewest public hospitals per uninsured population (0.27/100 000), which fell far below the national average of 0.71/100 000.
Total number of hospital beds
There were an estimated 102 229 hospital beds in SA. The provincial distribution of total hospital beds is shown in Fig. 2. The provincial distribution of the number of hospital beds according to hospital type is shown in Table 3.
GP had the largest overall number with 29 181 beds, comprising almost equal numbers of public and private beds. The large number of public hospital beds was as a result of the 4 tertiary-level and 11 regional-level hospitals. These hospitals typically have more beds as per their definition. The smallest total number of hospital beds were in NC (n=2 015) and NW (n=4 877). These provinces had no central hospitals and very few private beds. The fewest private beds were in LP (n=576) and NC (n=361).
Number of hospital beds per 100 000 population
The largest total number of beds per 100 000 population were in GP (n=225.95), followed by FS (n=216.80) and KZN (n=214.03).
The fewest beds per 100 000 population were in MP (n=123.50) and LP (n=138.83) (Table 4). There were far more private hospital beds per insured population (n=357.30) than public hospital beds per uninsured population (n=154.14). The largest number of private beds per insured 100 000 population were in FS (n=463.29), followed by GP (n=417.02) and KZN (n=359.21). The largest number of public sector beds available to uninsured patients per 100 000 population were in KZN (n=192.19), EC (n=179.34), NC (n=166.79) and FS (n=162.66). These provinces comprise predominantly rural areas.
Number of surgical beds
In SA, 22 758 beds were assigned as general surgical beds. Over half (53%) of these were located in the public sector.
Both private and public surgical beds were concentrated in GP, WC and KZN. The largest number of private surgical beds were in GP, whereas the largest number of public surgical beds were in KZN (Fig. 3, Table 5).
The district-level hospitals had an average of 131 beds and 20 surgical beds compared with regional-level hospitals, which had an average of 471 beds and 86 surgical beds. Tertiary-level hospitals had an average of 762 beds and 144 surgical beds. Private hospitals had an average of 144 beds and 48 surgical beds.
In the public sector, surgical beds comprised 17.2% of total hospital beds, ranging between 14.9% (LP) and 26.7% (WC). In the private sector, surgical beds comprised 33.8% of the total beds, with a range of 29.3% (MP) - 39.4% (EC). Overall in SA, surgical beds comprised 22.3% of total hospital beds.
Number of surgical beds per population
There were 41.55 surgical beds per 100 000 population, ranging from 22.68 (LP) to 56.44 (GP) (Table 6).
There was a striking difference between the number of surgical beds available to the public (n=26.45) compared with the number available to private patients (n=120.70). The fewest public beds per uninsured population were located in the less well-resourced provinces (MP, n=19.41; NW, n=19.83; and LP, n=20.85); however, these were not far behind the so-called well-resourced provinces (GP, n=25.31; and WC, n= 25.39). Surprisingly, EC, which comprises largely rural districts, had the second highest number of surgical beds available to uninsured patients (n=31.29) after KZN (n=34.31). The largest number of private surgical beds available to patients with health insurance were in FS (n=152.31), GP (n=140.80) and NW (n=114.36), whereas the fewest were in LP (n=40.22) and MP (n=67.12).
Surgically treatable diseases comprise > 30% of the burden of disease globally.  However, many people do not have access to adequate surgical care. Only 3.5% of the 243 million surgical procedures each year are performed in lower- and middle-income countries.  The current research provided an assessment of surgical beds as a metric of surgical services, even though this does have limitations.
Overview of national results in South Africa
Our study included 544 hospitals in SA. There were 257 district-level hospitals, 49 regional-level hospitals and 21 tertiary-level hospitals. The district-level hospitals had an average of 131 beds and 20 surgical beds. The regional-level hospitals had an average of 471 beds and 86 surgical beds. The tertiary-level hospitals had an average of 762 beds and 144 surgical beds. EC, surprisingly, had the largest number of public hospitals, whereas the largest total number of hospitals per population were in NC, followed by FS and EC - despite these provinces being perceived as less well resourced.
The number of public hospitals per uninsured population for the country were 0.71. GP fell far below this average with 0.27/100 000. However, GP had the third highest number of private hospitals per insured population (n=2.47), behind NW (n=2.78) and FS (n=3.19). This was not surprising, as GP was by far the 'wealthiest' in terms of GDP, which was valued at ZAR811 billion (USD112 billion).'91 When public and private facilities were combined (n=0.86), GP still fell below the national average of 1.00 hospital per 100 000 population.
Hospital beds as resource indicators
The largest proportion of the 102 229 hospital beds were located in GP (28%), KZN (22%), EC (12%) and WC (10%). GP, WC and KZN comprise large metropolitan areas, whereas EC is largely rural.
GP had the largest overall number of beds (n=29 181), comprising almost equal numbers of public and private beds. The reason for the large number of public hospital beds was the four tertiary-level and 11 regional-level hospitals in the province. Hospital beds per 100 000 were greatest in the metropolitan areas, with the largest total number of beds per population in GP (n=225.95), followed by FS (n=216.80) and KZN (n=214.03). Despite WC having large metropolitan areas, it had fewer hospital beds per population (n=175.22) than EC (n=184.43). When private hospital beds per population were compared with public hospital beds, a far greater maldistribution was found. Unexpectedly, the largest number of public hospital beds available to uninsured patients were in the less well-resourced provinces in SA.
When the number of surgical beds were compared across different levels of care, district-level hospitals reported a range of surgical beds from as few as 146 in NC to as many as 1 670 in KZN. In all provinces, district-level surgical beds were more numerous than regional-level surgical beds; yet, most district-level facilities refer their surgical cases to regional facilities for treatment. In particular, KZN district-level hospitals were found to be performing very few surgical procedures, except caesarean sections.  With far more surgical beds available at district-level facilities and the knowledge that surgery at this level is more cost-effective,  there needs to be a greater emphasis on performing surgery at district level. This would involve ensuring that operating theatres were 'functional' and that well-qualified surgical, anaesthetic and nursing staff were available to perform the procedures. Tertiary-level surgical beds were most numerous in EC (n=945), followed by GP (n=848) and WC (n=509).
Total number of hospital and surgical beds in the private sector
Private hospitals had an average of 144 beds and 48 surgical beds. Netcare, Life, Mediclinic and independent groups were the largest private hospital groups. There were 31 312 private hospital beds in SA. The largest proportion of these were in GP (n=14 326), KZN (n=4 802) and WC (n=4 391).
Private beds comprised 31% of total hospital beds in SA, which was a substantial increase from the 21% reported in 2006.  Forty-six percent of private beds were located in the most populous province, i.e. GP. There were 10 578 general surgical beds in the private sector. The largest number of private surgical beds were in GP (n=4 837), WC (n=1 560) and KZN (n=1 449). GP had three times as many surgical beds than other metropoles, such as WC and KZN. With its significant contribution to the national GDP, this was not surprising. MP had the fewest private surgical beds as a proportion of total number of beds (29.3%), and EC and NW had the largest proportion, with 39.3% each. In SA, private hospitals allocate approximately one-third of total hospital beds to surgical patients, whereas public hospitals allocate 15 - 26% of their beds to general surgery.
Rural provinces, such as EC, have a significant migration of patients towards the urban provinces (such as WC) in search of better healthcare, despite having a larger number of hospitals. This suggests that the number of resources may not reflect acceptable levels of care and provinces with fewer hospitals may have higher patient volumes. Despite the perception that WC and GP were 'wealthy' and had greater resources, they were often accessed by inhabitants of neighbouring provinces, thereby placing strain on the health systems. By implication, simply looking at the number of hospitals and beds does not translate into adequate healthcare or surgical provision, as bed utilisation rates are highest in these provinces. WC experienced a bed utilisation rate of 88.7, which is far higher than the national average of 68.3 and that of EC, which has a bed utilisation rate of 59.5 (the lowest on the country).  Furthermore, WC reported an average length of hospital stay of 3.7 days, whereas EC reported an average of 5.7 days.  This could be as a result of greater patient volumes in WC, which may result in mandatory higher patient turnover because of 'bed pressure'. Assessing readmission rates to hospital could provide an indication as to whether this higher turnover rate results in poorer outcomes and increased expenditure.
Tracking the migration patterns of patients may provide insight into their help-seeking behaviour. Migration is an important demographic process that shapes the distribution of the provincial population.  From 2011 to 2016, it was estimated that ~241 758 people migrated from EC; LP was estimated to experience an outflow of ~303 101 migrants. During the same period, GP and WC were estimated to experience an inflow of ~1 106 375 and 344 830 migrants, respectively. MP and NW also received a positive net migration, whereas EC, FS and LP experienced the largest outflow.  Understanding the ebb and flow of patients migrating between provinces in search of healthcare is critical and demonstrates that using infrastructure metrics, such as the number of hospitals and beds, is limited in the information provided to policymakers about resource availability.
There is unfortunately no uniform reporting of hospital beds, as countries use different definitions for the number of hospital beds. Nonetheless, since the 1990s, there has been a worldwide decrease in the number of beds.  SA has 186 hospital beds per 100 000 population, whereas according to the World Bank, Australia has the highest number, with 382 beds per 100 000 population. The UK (294/100 000) and USA (299/100 000) have 60% more hospital beds per population than SA. Brazil is an upper-middle-income country, with ~230 hospital beds per 100 000.  Kenya and Zambia are classified as low- and middle-income countries and have 140 and 190 hospital beds per 100 000, respectively.  Uganda, Tanzania and Mozambique have the fewest beds per population, indicating limited resources that coincide with being low-income countries. Surgical beds are currently not used as a measure of surgical resources and no global data exist as a comparative for SA's 41.55 surgical beds per 100 000. This could be as a result of surgical bed numbers being poor indicators of surgical capacity.
The measurement of the total number of beds had its shortcomings, as not all hospitals were included in the study. Specialised hospitals were excluded, as they did not perform general surgical procedures. District-level hospitals were non-uniform in the manner in which they allocated and reported surgical beds. The use of metrics for describing hospital beds as an indicator of provision of surgical care is flawed. Perhaps bed utilisation rates would provide more robust data. The proportion of patients with health insurance and access to the private sector may not represent the true number of patients who access private care. There are a number of uninsured patients who can afford out-of-pocket payments, which predisposes them to catastrophically high health expenditure. Similarly, patients with insurance may choose to access public sector hospitals.
Diseases that require surgery are an important and growing public health priority. Strengthening surgical systems will allow countries to tackle and reduce the surgical burden of disease, which may improve health outcomes globally. Our research provides part of an overview of the surgical infrastructure in SA and highlights some limitations of using these metrics to evaluate surgical capacity.
Acknowledgements. We wish to acknowledge the University of Cape Town.
Author contributions. AJD: collection, analysis and interpretation of the data, as well as drafting of the article. DK: critical revision of the article and final approval of the manuscript.
Conflicts of interest. None.
[1.] Ozgediz D, Jamison D, Cherian M, McQueen K. The burden of surgical conditions and access to surgical care in low- and middle-income countries. Bull World Health Organ 2008; 86(8):646-647. https://doi.org/10.2471/BLT.07.050435
[2.] Bickler S, Ozgediz D, Gosselin R, et al. Key concepts for estimating the burden of surgical conditions and the unmet need for surgical care. World J Surg 2010; 34(3):372-380. https://doi.org/10.1007/s00268-009-0261-6
[3.] Luboga S, Galukande M, Mabweijano J, Ozgediz D, Jayaraman S. Key aspects of health policy development to improve surgical services in Uganda. World J Surg 2010; 34(11):2511-2517. https://doi. org/10.1007/s00268-010-0585-2
[4.] Ozgediz D, Riviello R. The 'other' neglected diseases in global public health: Surgical conditions in sub-Saharan Africa. PLoS Med 2008; 5(6):e121. https://doi.org/10.1371/journal.pmed.0050121
[5.] Weiser TG, Regenbogen S, Thompson K, et al. An estimation of the global volume of surgery: A modelling strategy based on available data. Lancet 2008; 372(9633):139-144. https://doi. org/10.1016/S0140-6736(08)60878-8
[6.] Meara JG, Leather AJM, Hagander L, et al. Global surgery 2030: Evidence and solutions for achieving health, welfare, and economic development. Lancet 2015; 386(9993):569-624. https://doi.org/10.1016/ S0140-6736(15)60160-x
[7.] Provincial Government. http://www.southafrica.info/about/government/govprov (accessed 25 October 2017).
[8.] Statistics South Africa. Annual 2013/2014 report. www.statssa.gov.za (accessed 25 October 2017).
[9.] World Bank. South African overview. 2015. www.worldbank.org (accessed 25 October 2017).
[10.] Matsebula T, Willie M. Private hospitals. In: Harrison S, Bhana R, Ntuli A, eds. South African Health Review 2007. Durban: Health Systems Trust, 2007:159-164.
[11.] Massyn N, Day C, Peer N, Padarath A, Barron P, English R, eds. District Health Barometer. 2013/2014. Durban: Health Systems Trust, 2014.
[12.] Clarke D, Kong V, Handley J, Aldous C. A concept paper: Using the outcomes of common surgical conditions as quality metrics to benchmark district surgical services in South Africa as part of a systematic quality improvement programme. S Afr J Surg 2013; 51(3):84-86. https://doi.org/10.7196/sajs.1476
[13.] Chao T, Sharma K, Mandigo M, et al. Cost-effectiveness and its policy implications for global health: A systematic review and analysis. Lancet Glob Health 2014; 2(6):e334-e345. https://doi.org/10.1016/ S2214-109X(14)70213-X
[14.] World Bank. Hospital beds per capita. 2014. www.worldbank.org (accessed 25 October 2017).
Accepted 19 July 2017.
A J Dell, BSc, MB ChB, PhD; D Kahn, MB ChB, FCS (SA), ChM
Department of Surgery, Faculty of Health Sciences, and Groote Schuur Hospital, University of Cape Town, South Africa
Corresponding author: A J Dell (firstname.lastname@example.org)
Caption: Fig. 1. Provincial distribution of total number of hospitals in South Africa according to district municipality.
Caption: Fig. 2. Provincial distribution of total number of hospital beds in South Africa according to district municipality.
Caption: Fig. 3. Provincial distribution of total number of surgical beds in South Africa according to district municipality.
Table 1. Provincial distribution of total number of hospitals per 100 000 population, 2014 Province Population, Hospitals, Private Public n n hospitals, hospitals, n n EC 6 786 900 89 14 75 FS 2 786 800 46 16 30 GP 12 914 800 111 85 26 KZN 10 694 400 85 31 54 LP 5 630 500 45 7 37 MP 4 999 300 40 12 28 NC 1 166 700 21 4 17 NW 3 676 300 34 14 20 WC 6 116 300 74 34 40 SA 54 772 000 544 217 327 Province Total hospitals/ 100 000, n EC 1.31 FS 1.65 GP 0.86 KZN 0.79 LP 0.80 MP 0.80 NC 1.79 NW 0.92 WC 1.21 SA 1.00 EC = Eastern Cape; FS = Free State; GP = Gauteng Province; KZN = KwaZulu-Natal; LP = Limpopo Province; MP = Mpumalanga Province; NC = Northern Cape; NW = North West; WC = Western Cape; SA = South Africa. Table 2. Comparison of public and private hospitals per 100 000 population, 2014 Medical aid Province coverage, %  Public hospitals, n EC 11.4 75 FS 18.0 30 GP 26.6 26 KZN 12.5 54 LP 8.7 37 MP 13.3 28 NC 15.4 17 NW 13.7 20 WC 25.5 40 SA 16.0 327 Public hospitals per 100 000 uninsured Province population, n Private hospitals, n EC 1.24 14 FS 1.31 16 GP 0.27 85 KZN 0.58 31 LP 0.71 7 MP 0.64 12 NC 1.71 4 NW 0.63 14 WC 0.87 34 SA 0.71 217 Private hospitals per 100 000 insured Province population, n EC 1.88 FS 3.19 GP 2.47 KZN 2.32 LP 1.43 MP 1.80 NC 2.29 NW 2.78 WC 2.16 SA 2.48 EC = Eastern Cape; FS = Free State; GP = Gauteng Province; KZN = KwaZulu-Natal; LP = Limpopo Province; MP = Mpumalanga Province; NC = Northern Cape; NW = North West; WC = Western Cape; SA = South Africa. Table 3. Provincial distribution of hospital beds according to hospital type, n Hospital Province District, n Regional, n Central, n EC 6 252 555 4 026 FS 1 568 1 606 543 GP 2 722 6 412 5 721 KZN 8 399 8 329 1 359 LP 4 431 1 579 1 231 MP 3 227 915 650 NC 960 694 0 NW 1 396 2 016 0 WC 2 659 1 172 2 495 SA 31 614 23 278 16 025 Province Private, n Total, n EC 1 684 12 517 FS 2 325 6 042 GP 14 326 29 181 KZN 4 802 22 889 LP 576 7 817 MP 1 382 6 174 NC 361 2 015 NW 1 465 4 877 WC 4 391 10 717 SA 31 312 102 229 EC = Eastern Cape; FS = Free State; GP = Gauteng Province; KZN = KwaZulu-Natal; LP = Limpopo Province; MP = Mpumalanga Province; NC = Northern Cape; NW = North West; WC = Western Cape; SA = South Africa. Table 4. Comparison of public hospital beds per uninsured population, private hospital beds per insured population and total hospital beds per total population, 2014 Public hospital beds per 100 000 Public hospital uninsured Private Province beds, n population, n hospital beds, n EC 10 833 179.34 1 684 FS 3 717 162.66 2 325 GP 14 855 155.44 14 326 KZN 18 087 192.19 4 802 LP 7 241 139.79 576 MP 4 792 110.18 1 382 NC 1 654 166.79 361 NW 3 412 106.68 1 465 WC 6 326 138.67 4 391 SA 70 917 154.14 31 312 Private hospital beds per Total beds 100 000 insured per 100 000 Province population, n Total beds, n population, n EC 217.65 12 517 184.43 FS 463.49 6 042 216.80 GP 417.02 29 181 225.95 KZN 359.21 22 889 214.03 LP 117.59 7 817 138.83 MP 207.85 6 174 123.50 NC 200.92 2 015 172.71 NW 290.87 4 877 132.66 WC 281.54 10 717 175.22 SA 357.30 102 229 186.64 EC = Eastern Cape; FS = Free State; GP = Gauteng Province; KZN = KwaZulu-Natal; LP = Limpopo Province; MP = Mpumalanga Province; NC = Northern Cape; NW = North West; WC = Western Cape; SA = South Africa. Table 5. Provincial distribution of surgical beds according to hospital type, n Province Hospital District, n Regional, n Central, n Private, n EC 793 152 945 663 FS 559 336 60 764 GP 428 1 176 848 4 837 KZN 1 670 1 522 354 1 459 LP 715 235 130 197 MP 605 132 107 406 NC 146 146 0 126 NW 220 407 0 576 WC 455 210 509 1 560 SA 5 591 4 316 2 953 10 578 Province Total, n EC 2 553 FS 1 383 GP 7 289 KZN 4 651 LP 1 277 MP 1 250 NC 418 NW 1 203 WC 2 734 SA 22 758 EC = Eastern Cape; FS = Free State; GP = Gauteng Province; KZN = KwaZulu-Natal; LP = Limpopo Province; MP = Mpumalanga Province; NC = Northern Cape; NW = North West; WC = Western Cape; SA = South Africa. Table 6. Surgical beds per 100 000 population according to sector and province, n Public hospital surgical beds per 100 000 Public hospital uninsured Private hospital Province surgical beds, n population, n surgical beds, n EC 1 890 31.29 663 FS 619 27.09 764 GP 2 452 25.31 4 837 KZN 3 192 34.31 1 449 LP 1 080 20.85 197 MP 844 19.41 406 NC 292 29.10 126 NW 627 19.83 576 WC 1 174 25.39 1 560 SA 12 170 26.45 10 578 Private hospital surgical beds per Total surgical 100 000 insured Total surgical beds per 100 000 Province population, n beds, n population, n EC 85.69 2 553 37.62 FS 152.31 1 383 49.62 GP 140.80 7 289 56.44 KZN 108.39 4 641 43.40 LP 40.22 1 277 22.68 MP 67.12 1 250 25.00 NC 70.13 418 35.83 NW 114.36 1 203 32.72 WC 100.02 2 734 44.70 SA 120.70 22 758 41.55 EC = Eastern Cape; FS = Free State; GP = Gauteng Province; KZN = KwaZulu-Natal; LP = Limpopo Province; MP = Mpumalanga Province; NC = Northern Cape; NW = North West; WC = Western Cape; SA = South Africa.
|Printer friendly Cite/link Email Feedback|
|Author:||Dell, A.J.; Kahn, D.|
|Publication:||South African Medical Journal|
|Date:||Dec 1, 2017|
|Previous Article:||Mortality trends in the City of Cape Town between 2001 and 2013: Reducing inequities in health.|
|Next Article:||Acne in South African black adults: A retrospective study in the private sector.|