DHB 2006/07 - Health Systems Trust

Section A: Indicator Comparisons by District
3.3 Average Length of Stay Peter Barron
The average length of stay (ALOS) measures how much time patients spend in district hospitals. It
is calculated by dividing the number of patient days by the number of separations, which include
transfers, discharges and deaths. District hospitals generally admit acute, relatively uncomplicated
patients and the idea is to treat them and discharge them as soon as is possible.
The ALOS is a proxy measure for the quality of care received as well as of the efficiency of the hospital.
It is one of the best markers for what is happening in a hospital and a persistently high ALOS means
that patients are being kept in hospital for too long. A very low ALOS means that the quality of care is
likely to have been compromised.
District View
As can be seen in Map 6 and Figure 35 there was a wide variation in the
ALOS in South Africa in 2006/07 with an average value for the country of
4.4 days. This increased from 4.3 in 2005/06. The range was from 2.0 days
in Kgalagadi (NC) to 8.2 in Alfred Nzo (EC). Because many of the districts
contain more than one district hospital the district averages seen in this
figure conceal greater individual hospital variations. There were no data
from Metsweding (GP) as this district does not have district hospitals. As with
2005/06, the 10 districts with the highest ALOS were all rural districts in the
Eastern Cape and KwaZulu-Natal provinces.
There were distinct provincial differences. All the Northern Cape, Western
Cape and four of the five districts in the Free State had an ALOS of less than
four days. On the other hand, six of the seven Eastern Cape districts and 10
of the 11 KwaZulu-Natal districts had an ALOS of greater than four days.
The remaining provinces were clustered in the middle around four days.
There were large intra-provincial variations in the Eastern Cape and
KwaZulu-Natal with a wide range between the district with the lowest and
the district with the highest ALOS. The rest of the provinces had relatively
narrow ranges and all three Mpumalanga districts had almost the same
ALOS, around 4.4 days.
Map 6: Average length of stay in district hospitals in South Africa, 2006/07
Average length of stay, 2006/07
Legend
ALOS_06
no data
< 3 days
3 - 3.9
4 - 4.9
5 - 5.9
6 days and over
40
THE DHIS INDICATORS PRESENTED HERE ARE AS RECEIVED FROM THE NATIONAL DHIS AND HAVE NOT BEEN ALTERED BY THE AUTHORS OR HST