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Patterns of orthopedic and trauma admissions to a tertiary teaching and referral health facility in Kenya: Chart review

Tertiary hospitals in resource-limited countries should treat referred patients but in reality, are the first level of care for the vast majority of patients. As a result, the tertiary facility effectively functions as a primary health care facility. The urban phenomenon of widespread self-referral...

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Autores principales: Omondi, Maxwell Philip, Mwangi, Joseph Chege, Sitati, Fred Chuma, Onga’ngo, Herbert
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10191292/
https://www.ncbi.nlm.nih.gov/pubmed/37195922
http://dx.doi.org/10.1371/journal.pgph.0001425
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author Omondi, Maxwell Philip
Mwangi, Joseph Chege
Sitati, Fred Chuma
Onga’ngo, Herbert
author_facet Omondi, Maxwell Philip
Mwangi, Joseph Chege
Sitati, Fred Chuma
Onga’ngo, Herbert
author_sort Omondi, Maxwell Philip
collection PubMed
description Tertiary hospitals in resource-limited countries should treat referred patients but in reality, are the first level of care for the vast majority of patients. As a result, the tertiary facility effectively functions as a primary health care facility. The urban phenomenon of widespread self-referral is associated with low rates of formal referral from peripheral health facilities. The study objective was to determine the patterns of orthopaedic and trauma admissions to Kenyatta National Hospital. This was descriptive study design. 905 patient charts were reviewed in 2021. The mean age was 33.8 years (SD 16.5) with range of 1–93 years. Majority 66.3% were between 25–64 years with those above 65 years being 40 (4.4%). Children 0–14 years comprised 10.9% of the admissions. Of the 905 admissions, 80.7% were accident and trauma-related admissions while 17.1% were non-trauma related admissions. About 50.1% were facility referrals while 49.9% were walk-ins. Majority of admissions were through Accident and Emergency Department 78.1%, Corporate Outpatient Care 14.9% and orthopedic Clinic 7.0%. About 78.7% were emergency admissions while 20.8% were elective admissions. Approximately 48.5% were due to Road Traffic Accidents and 20.9% due to falls. Close to 44.8% were casual workers and 20.2% unemployed. About 34.0% attained primary education and 35.0% secondary education. About 33.2% of female admissions were due to non-trauma conditions as compared to male admissions (12.8%) (p<0.001). Admissions for those aged 25–64 years were 3.5 more likely to have emergency admission as compared to those aged 0–14 years. Male were 65.1% less likely to have elective admissions compared to female (p<0.001). Whereas lower limb injuries and non-trauma related conditions were the most commonly admitted conditions, Lower limb injury and spine cases were mostly facility referred while non-trauma conditions were walk-in patients. Vast majority (89.2%) of admissions were from Nairobi Metropolitan region.
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spelling pubmed-101912922023-05-18 Patterns of orthopedic and trauma admissions to a tertiary teaching and referral health facility in Kenya: Chart review Omondi, Maxwell Philip Mwangi, Joseph Chege Sitati, Fred Chuma Onga’ngo, Herbert PLOS Glob Public Health Research Article Tertiary hospitals in resource-limited countries should treat referred patients but in reality, are the first level of care for the vast majority of patients. As a result, the tertiary facility effectively functions as a primary health care facility. The urban phenomenon of widespread self-referral is associated with low rates of formal referral from peripheral health facilities. The study objective was to determine the patterns of orthopaedic and trauma admissions to Kenyatta National Hospital. This was descriptive study design. 905 patient charts were reviewed in 2021. The mean age was 33.8 years (SD 16.5) with range of 1–93 years. Majority 66.3% were between 25–64 years with those above 65 years being 40 (4.4%). Children 0–14 years comprised 10.9% of the admissions. Of the 905 admissions, 80.7% were accident and trauma-related admissions while 17.1% were non-trauma related admissions. About 50.1% were facility referrals while 49.9% were walk-ins. Majority of admissions were through Accident and Emergency Department 78.1%, Corporate Outpatient Care 14.9% and orthopedic Clinic 7.0%. About 78.7% were emergency admissions while 20.8% were elective admissions. Approximately 48.5% were due to Road Traffic Accidents and 20.9% due to falls. Close to 44.8% were casual workers and 20.2% unemployed. About 34.0% attained primary education and 35.0% secondary education. About 33.2% of female admissions were due to non-trauma conditions as compared to male admissions (12.8%) (p<0.001). Admissions for those aged 25–64 years were 3.5 more likely to have emergency admission as compared to those aged 0–14 years. Male were 65.1% less likely to have elective admissions compared to female (p<0.001). Whereas lower limb injuries and non-trauma related conditions were the most commonly admitted conditions, Lower limb injury and spine cases were mostly facility referred while non-trauma conditions were walk-in patients. Vast majority (89.2%) of admissions were from Nairobi Metropolitan region. Public Library of Science 2023-05-17 /pmc/articles/PMC10191292/ /pubmed/37195922 http://dx.doi.org/10.1371/journal.pgph.0001425 Text en © 2023 Omondi et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Omondi, Maxwell Philip
Mwangi, Joseph Chege
Sitati, Fred Chuma
Onga’ngo, Herbert
Patterns of orthopedic and trauma admissions to a tertiary teaching and referral health facility in Kenya: Chart review
title Patterns of orthopedic and trauma admissions to a tertiary teaching and referral health facility in Kenya: Chart review
title_full Patterns of orthopedic and trauma admissions to a tertiary teaching and referral health facility in Kenya: Chart review
title_fullStr Patterns of orthopedic and trauma admissions to a tertiary teaching and referral health facility in Kenya: Chart review
title_full_unstemmed Patterns of orthopedic and trauma admissions to a tertiary teaching and referral health facility in Kenya: Chart review
title_short Patterns of orthopedic and trauma admissions to a tertiary teaching and referral health facility in Kenya: Chart review
title_sort patterns of orthopedic and trauma admissions to a tertiary teaching and referral health facility in kenya: chart review
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10191292/
https://www.ncbi.nlm.nih.gov/pubmed/37195922
http://dx.doi.org/10.1371/journal.pgph.0001425
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