An investigation into the expenditure per patient day equivalent for public hospitals in North West Province, South Africa

Abstract

The North West Department of Health initiated this study to investigate the rising healthcare expenditures in public hospitals within the North West Province compared to other regions. The study focuses on identifying key factors contributing to this financial strain. The literature review emphasises social determinants of health in South African public hospitals, particularly within the North West Province. It explores various influences on healthcare spending, encompassing socio-economic factors, infrastructure, and broader systemic impacts. Following ethical and scientific clearance, the data collection process commenced through semi-structured interviews, applying a qualitative descriptive methodology. These interviews served as a rich source of qualitative data, offering insights into the factors influencing the high ExPDE. Subsequently, the collected data underwent analysis using the Atlas.Ti software. The detailed analysis categorises seven themes impacting the increased healthcare expenditures in the province's healthcare facilities. These themes cover multiple aspects, including challenges in resource allocation, staffing shortages, irregularities in procurement, prolonged patient stays, technological limitations, and broader socio-economic effects. Visualisation of these themes underscores their collective impact on the financial dynamics of the healthcare system. The study concludes by proposing strategic recommendations aimed at addressing identified challenges. These recommendations seek to enhance cost management strategies and operational efficiency, optimise the workforce, refine procurement processes, integrate technology, and streamline administrative procedures. The insights aim to assist the North West Department of Health foster a more sustainable healthcare system and improve patient care.