A descriptive analysis of the casemix presenting to a tertiary hospital emergency centre in East London, South Africa

INTRODUCTION: Emergency centres are most often the point of entry to the healthcare system for patients presenting with emergencies. Even though emergency medicine has developed rapidly in certain regions of South Africa, it is yet to flourish in the Eastern Cape. A paucity of data exists with regards to the demographic and disease profile of patients presenting to Eastern Cape emergency centres. This study describes the casemix presenting to a tertiary hospital emergency centre in East London in the Eastern Cape. METHODS: A retrospective descriptive study was conducted of all patients presenting to Frere Hospital emergency centre from 1st of August 2019 to 31(st) of October 2019. Data were manually collected from the emergency centre paper-based register for the study period and included: patient demographics, geographical location, triage category, presenting complaint, disposition, and process times. Descriptive statistics were used to describe all variables. RESULTS: A total of 6 204 patients presented during the study period. The median age was 31 years, with a male predominance of 56%. Lower acuity triage categories (green and yellow) represented 67% of all cases. Trauma comprised 56% of all presentations, with assault being the most prevalent mechanism of injury in the adult population (n = 1 460, 48%). Sundays (18%) and Mondays (20%) had the highest patient caseload. The majority of patients were discharged home (n = 4 257, 69%) of which 79% had lower acuity triage categories. The majority of patients lived within a 20 km radius of Frere Hospital (n = 4 689, 77%). CONCLUSION: This descriptive study provides essential data that could guide further development of emergency care systems within the Eastern Cape. A high trauma burden, comprising predominantly of lower acuity presentations are described. Social and economic determinants of violence must be addressed and multisectoral interventions are required to reduce the high burden of trauma.