South Africa’s hospital sector : old divisions and new developments

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dc.contributor.authorRanchod, Shivanien_ZA
dc.contributor.authorAdams, Cherylen_ZA
dc.contributor.authorBurger, Ronelleen_ZA
dc.contributor.authorCarvounes, Angelikien_ZA
dc.contributor.authorDreyer, Kathrynen_ZA
dc.contributor.authorSmith, Anjaen_ZA
dc.contributor.authorStewart, Jacquien_ZA
dc.contributor.authorVan Biljon, Chloeen_ZA
dc.date.accessioned2020-03-11T09:26:00Z
dc.date.available2020-03-11T09:26:00Z
dc.date.issued2017
dc.descriptionCITATION: Ranchod, S., et al. 2017. South Africa’s hospital sector : old divisions and new developments. South African Health Review, 2017(1):101-110.
dc.descriptionThe original publication is available at https://www.hst.org.za
dc.description.abstractThe hospital sector in South Africa mirrors deep inequalities in the country as a whole. The private, for-profit hospital sector is well resourced and caters to a population that tends to be wealthier, urban and more likely to be formally employed. The public-hospital sector, catering to the majority of South Africans, faces lower human-resourcing ratios, financial constraints and ageing infrastructure. This chapter contextualises the development of the two sectors, describes the current divide, and considers the implications in terms of equity, access and quality of care. A unique dataset of quality-accreditation-survey scores was used, which allowed for analysis of the two sectors according to a common yardstick. These data reflect a wide array of structure- and process-related quality indicators; in addition, the patient perspective reflected in data from the General Household Survey was used to illustrate the quality differential. The research provides evidence of the polarisation between public and private facilities: private facilities consistently scored above public facilities across a range of accreditation categories, and there was far greater variability in the scores achieved by public facilities. The same polarised relationship was found to hold across key sub-components of the scores, such as management and leadership of hospitals in the two sectors. We conclude that there is a need for the measurement of health outcomes across the system. Policy attention is required in terms of accountability and quality improvement. A focus on improving value in the system will, by necessity, have to engage with the discrepancies between the sectors.en_ZA
dc.description.urihttps://www.hst.org.za/publications/Pages/HST-South-African-Health-Review-2017.aspx
dc.description.versionPublisher's version
dc.format.extent10 pages ; illustrations
dc.identifier.citationRanchod, S., et al. 2017. South Africa’s hospital sector : old divisions and new developments. South African Health Review, 2017(1):101-110
dc.identifier.issn1025-1715 (online)
dc.identifier.urihttp://hdl.handle.net/10019.1/107608
dc.language.isoen_ZAen_ZA
dc.publisherHealth Systems Trust
dc.rights.holderHealth Systems Trust
dc.subjectHospitals -- South Africa -- Developmenten_ZA
dc.subjectPrimary health care -- South Africaen_ZA
dc.titleSouth Africa’s hospital sector : old divisions and new developmentsen_ZA
dc.typeArticleen_ZA
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