Resumo

RICHARDS, M; LE ROUX, D  e  PIENAAR, D. How far? Travel burdens for children admitted to hospitals in the Western Cape Province of South Africa. SAMJ, S. Afr. med. j. [online]. 2024, vol.114, n.4, pp.36-41. ISSN 2078-5135.  http://dx.doi.org/10.7196/SAMJ.2024.v114i4.1393.

BACKGROUND: The ability to access effective hospital care for children is a significant determinant of good health outcomes. The Western Cape Province is a large land area with a wide array of human settlements, both in urban and rural spaces. For many children in the Western Cape, after-hours access to healthcare becomes constrained when primary care clinics close and hospitals are either far away or difficult to get to. The cumulative travel burden of communities across this area is not known. The recently established data-gathering capacity of the Provincial Health Data Centre of the Western Cape represents a new capacity to study this OBJECTIVES: To describe the cumulative travel burdens of children in communities throughout the Western Cape Province, and how they compare relative to one another, with a particular focus on the after-hours period in a week METHODS: Over a period of 5 years from 2017 to 2021, all the admission details to every hospital in the Western Cape Province of children <18 years of age were collected, with basic demographic and disease data, including place of residence. The distance each child travelled to their first admission facility was calculated and represented within defined communities across the metro of Cape Town and the rural Western Cape RESULTS: There were 574 220 admissions over the 5-year period, of which 360 783 were able to be used for travel analysis. The majority of admissions were for children under 5 years of age, were in the City of Cape Town and occurred after hours. Median travel distance was less for children outside of Cape Town, but the range of travelled distances was greater. Communities across the Western Cape, particularly rural communities, reflected significant variation in their cumulative travel burdens CONCLUSION: Using a large health dataset, this study demonstrates in a novel way for South Africa the distances children travel to access admission facilities. A wide variation exists across all parts of the province, but particularly in rural areas. These findings could be further interrogated for people's choices of facility and method of travel. Detailed service area modelling and extending primary care working hours are potential considerations for improving access at scale and at the local community level

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