Abstract
Introduction The latest national healthcare reform policies of Sri Lanka include the development of accident and emergency (A&E) departments in all major hospitals. Provincial General Hospital Kurunegala (PGHK) is a home to the first established A&E department in Sri Lanka. PGHK provides services to a population of 2.4 million spread out in the North Western Province and part of the Sabaragamuwa Province. This study was carried out to identify the pattern of all admissions to the A&E department of PGHK. Methods The prospective observational study was carried out from July 1, 2016, to June 30, 2017 (one year) to identify the pattern of admissions to the A&E department. Results There were 49,213 admissions to PGHK's A&E department during the study period. The average number of admissions was 135 (±17.9) per day. The percentage of deaths in the A&E department was 0.21%. The mean age of admitted patients was 46.7 (±21.7) years. A further 62% of admitted patients were males. The number of medical, surgical, paediatric, and gynaecological and obstetrical admissions was 55%, 42%, 3.5%, and 0.22%, respectively. Among the common emergency medical presentations, 34% were chest pain, 11% patients presented with unilateral weakness and/or slurring of speech, 10% covered dyspnoea, and 9% complained of dizziness/giddiness. Among emergency surgical presentations, 83% were trauma due to accidents, of which 27% were road-traffic-related accidents (RTAs). Discussion. The A&E department of PGHK provides services to a significantly high number of health emergencies every day. The majority of these admissions was due to chest pain and trauma related to accidents. The lower recorded number of paediatric and gynaecological and obstetrical emergencies presented to the A&E department is a result of a government policy mandating the admission of these types of patients directly to their respective wards. Further infrastructure development, staff recruitment, and training have to be planned and implemented to address the significantly high number of admissions to the A&E Department of PGHK.
Highlights
Sri Lanka is a South Asian island nation in the Indian Ocean and has a population of nearly 20 million (20.95 million) [1, 2]
Study Setting. e study was conducted in Provincial General Hospital Kurunegala (PGHK), which is situated in the North Western Province of Sri Lanka
Demographic and Baseline Information. ere were 49,213 admissions to the A&E department during the study period. ere were 32,911 (66.9%) self-referrals and 16,034 (32.6%) transfers from hospitals. ere were 255 (0.5%) referrals by specialists and general practitioners. ere were 3,773 (23.5%) admissions that were transferred from base hospitals and 12,261 (76.5%) admissions transferred from other peripheral hospitals
Summary
Sri Lanka is a South Asian island nation in the Indian Ocean and has a population of nearly 20 million (20.95 million) [1, 2]. In Sri Lanka, both public and private sectors provide health care. E network of these curative institutions is made up of national hospitals, teaching hospitals, provincial general hospitals, district general hospitals, base hospitals, and peripheral units such as divisional hospitals and rural hospitals. National hospitals and teaching hospitals provide health care in the four main specialities (medicine, surgery, paediatrics, and gynaecology and obstetrics), and most provide health care in the important subspecialities (cardiology, pulmonology, ophthalmology, orthopaedic surgery, etc.). A provincial general hospital is a type of general hospital with more facilities. Each district has one general hospital (called a district general hospital) which provides care in the four. Base hospitals provide health care only in the four main specialities. Divisional hospitals, peripheral units, and rural hospitals have a very limited number of facilities and do not provide any specialized care. Divisional hospitals, peripheral units, and rural hospitals have a very limited number of facilities and do not provide any specialized care. e North Western Province (Figure 1), where PGHK is located, has one district general hospital, six base hospitals, and 12 divisional hospitals [3]
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