SAHR 2007 - Health Systems Trust

Health and Related Indicators 15
Health Services Indicators
Health facilities
The national targets for districts include a large number of
indicators:
➤ Expenditure per PHC headcount – R100
➤ PHC utilisation rate – 2.5 visits per annum
➤ PHC utilisation rate for under 5 year olds – 5 visits per
annum
➤ Supervision visit rate – 100%
➤ Bed utilisation rate – 72%
➤ Surgical fatality rate – 3%
➤ Average length of stay – 3.2 days
➤ Expenditure per patient day equivalent – R814
The NDoH Annual Report 2005/06 makes a number of
claims of success:
➤ “Use of primary health care services has increased
steadily. In 1998 there were 67 million visits to these
services countrywide. By 2002 this figure had risen
to 85 million and in 2004 it exceeded 98 million. The
average number of annual visits was 1.8 per person in
1998 and increased to 2.1 by 2004. For children under
five years – a critical stage of development – visits are
more frequent, averaging 4.5 a year in 2004.”
It does, however, note important gaps:
➤ “Presently not all health districts are able to provide the
full range of services stipulated in national standards:
Two out of three districts meet the requirement. Those
that do not offer the full package of services nevertheless
provide a significant range of services.”
Data from the DHIS are shown in Table 43 for the provin-
Health Services – Health facilities
cial level. However, the real differences exist at district level,
and these data can be accessed from the District Health
Barometer reports. Data from the PHC facilities surveys are,
however, from a number of years ago and will not necessarily
reflect the actual situation. The following section provides
the most up-to-date available pictures of the health districts,
including data on private hospitals. Other private sector
facilities are, however, widely used by South Africans. This
aspect is covered in each year’s General Household Survey.
The 2006 report [StatsSA GHS 2006] made the following
summary points:
➤
➤
➤
➤
based on the survey, only 13.7% of the population was
covered by a medical scheme;
among those who reported being injured or ill in the
month before the survey, more sought care in the public
sector (61.2%) than in the private sector;
the percentage seeking care in the private sector varied
from 28% in NC to 50.6% in GP;
satisfaction with the service received did not vary
considerably between the public sector (84.2%) and
the private sector (95.6%);
➤ of those who had consulted a health worker, 19.4%
described the cost of care as “too high”, but this had
decreased from 2002 (31.3%).
Table 40 shows how these results have changed since
2002.
Other data on private sector utilisation can be gathered
from the annual reports of the Council for Medical Schemes
[Medical Schemes 2005-6 (and other years)]. For example
the average number of visits to a general practitioner (the
more usual primary care provider) per beneficiary was 3.4/
year in 2005, marginally increased from 3.3 in 2004. The
average length of stay in private hospitals in 2005 was 1.4
days.
Table 40: Place of consultation, satisfaction with service and reasons for non-consultation (%) of those injured / ill,
2002-2006
2002 2003 2004 2005 2006
Of those who were injured / ill in June and who consulted a health worker:
Public sector consultations 57.8 57.6 58.5 59.4 61.2
Private sector consultations 42.2 42.4 41.5 40.6 38.5
Public sector – satisfaction with service 81.6 82.3 82.4 82.1 84.2
Private sector – satisfaction with service 95.3 94.3 96.9 96.0 95.6
Of those who were injured / ill in June and did not consult health worker
Reasons for not consulting health worker:
Too expensive 31.3 29.7 21.0 19.2 19.4
Too far 6.8 7.9 7.3 7.6 8.6
Source: StatsSA GHS 2006.
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