The use of emergency medical services for palliative situations in Western Cape Province, South Africa: A retrospective, descriptive analysis of patient records
Background. An estimated 56.8 million people require palliative care annually, while only 14% receive such care. This imbalance is particularly acute in low-to middle-income countries (LMICs), where up to 80% of patients requiring palliative care reside. To correct this imbalance, integration b...
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South African Medical Association
2023-11-01
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| Series: | South African Medical Journal |
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| Online Access: | https://samajournals.co.za/index.php/samj/article/view/1136 |
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| author | C Gage B Spies K Crombie L Gwyther W Stassen |
| author_facet | C Gage B Spies K Crombie L Gwyther W Stassen |
| author_sort | C Gage |
| collection | DOAJ |
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Background. An estimated 56.8 million people require palliative care annually, while only 14% receive such care. This imbalance is particularly acute in low-to middle-income countries (LMICs), where up to 80% of patients requiring palliative care reside. To correct this imbalance, integration between palliative services and other disciplines has been recommended. While improved palliative care integration is a priority in the South African (SA) LMIC context, emergency medical services (EMS) and palliative care remain non-integrated. This has resulted in poor palliative situation management by EMS and a lack of research concerning their intersection.
Objective. To examine EMS use for palliative situations in the Western Cape (WC) Province of SA by describing frequency of intersection, patient characteristics and outcomes.
Methods. An observational, descriptive, retrospective patient record review was employed at two hospitals with palliative care services in the WC. All patient records of those who arrived at the hospitals between 1 January 2020 and 31 December 2020 via EMS conveyance leading to palliative care provision were included in the study.
Results. In total, 1 207 unique patients received palliative care services at both hospitals during the study period. Of these, 395 (33%) made use of EMS for hospital conveyance on 494 occasions. The median (range) patient age was 60 (20 - 93) years, and most transports involved male patients (54%, n=265). Family members were the primary caregivers in most instances (89%, n=440), dyspnoea was the chief complaint (36%, n=178) and cancer was the most frequent diagnosis (32%, n=159). The median length of hospital stay was 6 days, with most patients discharged home (60%, n=295).
Conclusion. EMS in SA frequently encounter palliative situations for symptoms that may be managed within their scope of practice. Consequently, it appears that EMS have an important role to fulfil in the care of patients with palliative needs. Integrating EMS and palliative care may result in improved palliative care provision and, therefore, EMS and palliative care integration would be beneficial in SA.
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| format | Article |
| id | doaj-art-7bee28af60e441b4a962511271ce668d |
| institution | Kabale University |
| issn | 0256-9574 2078-5135 |
| language | English |
| publishDate | 2023-11-01 |
| publisher | South African Medical Association |
| record_format | Article |
| series | South African Medical Journal |
| spelling | doaj-art-7bee28af60e441b4a962511271ce668d2025-02-10T12:26:40ZengSouth African Medical AssociationSouth African Medical Journal0256-95742078-51352023-11-011131110.7196/SAMJ.2023.v113i11.1136The use of emergency medical services for palliative situations in Western Cape Province, South Africa: A retrospective, descriptive analysis of patient recordsC Gage0https://orcid.org/0000-0001-7063-4007B Spies1K Crombie2L Gwyther3W Stassen4https://orcid.org/0000-0002-1486-4446Division of Emergency Medicine, Faculty of Health Sciences, University of Cape Town, South AfricaDivision of Emergency Medicine, Faculty of Health Sciences, University of Cape Town, South AfricaDepartment of Medicine, Faculty of Health Sciences, University of Cape Town, South AfricaDivision of Interdisciplinary Palliative Care and Medicine, Faculty of Health Sciences, University of Cape Town, South AfricaDivision of Emergency Medicine, Faculty of Health Sciences, University of Cape Town, South Africa Background. An estimated 56.8 million people require palliative care annually, while only 14% receive such care. This imbalance is particularly acute in low-to middle-income countries (LMICs), where up to 80% of patients requiring palliative care reside. To correct this imbalance, integration between palliative services and other disciplines has been recommended. While improved palliative care integration is a priority in the South African (SA) LMIC context, emergency medical services (EMS) and palliative care remain non-integrated. This has resulted in poor palliative situation management by EMS and a lack of research concerning their intersection. Objective. To examine EMS use for palliative situations in the Western Cape (WC) Province of SA by describing frequency of intersection, patient characteristics and outcomes. Methods. An observational, descriptive, retrospective patient record review was employed at two hospitals with palliative care services in the WC. All patient records of those who arrived at the hospitals between 1 January 2020 and 31 December 2020 via EMS conveyance leading to palliative care provision were included in the study. Results. In total, 1 207 unique patients received palliative care services at both hospitals during the study period. Of these, 395 (33%) made use of EMS for hospital conveyance on 494 occasions. The median (range) patient age was 60 (20 - 93) years, and most transports involved male patients (54%, n=265). Family members were the primary caregivers in most instances (89%, n=440), dyspnoea was the chief complaint (36%, n=178) and cancer was the most frequent diagnosis (32%, n=159). The median length of hospital stay was 6 days, with most patients discharged home (60%, n=295). Conclusion. EMS in SA frequently encounter palliative situations for symptoms that may be managed within their scope of practice. Consequently, it appears that EMS have an important role to fulfil in the care of patients with palliative needs. Integrating EMS and palliative care may result in improved palliative care provision and, therefore, EMS and palliative care integration would be beneficial in SA. https://samajournals.co.za/index.php/samj/article/view/1136Emergency MedicinePalliative careEmergency Medical ServicesParamedic |
| spellingShingle | C Gage B Spies K Crombie L Gwyther W Stassen The use of emergency medical services for palliative situations in Western Cape Province, South Africa: A retrospective, descriptive analysis of patient records South African Medical Journal Emergency Medicine Palliative care Emergency Medical Services Paramedic |
| title | The use of emergency medical services for palliative situations in Western Cape Province, South Africa: A retrospective, descriptive analysis of patient records |
| title_full | The use of emergency medical services for palliative situations in Western Cape Province, South Africa: A retrospective, descriptive analysis of patient records |
| title_fullStr | The use of emergency medical services for palliative situations in Western Cape Province, South Africa: A retrospective, descriptive analysis of patient records |
| title_full_unstemmed | The use of emergency medical services for palliative situations in Western Cape Province, South Africa: A retrospective, descriptive analysis of patient records |
| title_short | The use of emergency medical services for palliative situations in Western Cape Province, South Africa: A retrospective, descriptive analysis of patient records |
| title_sort | use of emergency medical services for palliative situations in western cape province south africa a retrospective descriptive analysis of patient records |
| topic | Emergency Medicine Palliative care Emergency Medical Services Paramedic |
| url | https://samajournals.co.za/index.php/samj/article/view/1136 |
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