An Evaluation of Inpatient Morbidity and Critical Care Provision in Zambia

This study aims to objectively measure demand for critical care services in a southern African tertiary referral centre. We carried out a point prevalence study of medical and surgical admissions over a forty-eight hour period at the University Teaching Hospital, Lusaka, recording; age, sex, diagnosis, human immune-deficiency virus status and national early warning score. One hundred and twenty medical and surgical admissions were studied. Fifty-four patients (45%) had objective evidence of requirement for critical care review “and usually” admission according to Royal College of Physicians (UK) guidelines. A greater than expected human immune-deficiency virus rate was also noted: 53 of 75 tested patients (71%). When applied to the estimated 17496 annual acute admissions this would equate to 7873 patients requiring critical care input annually at this hospital alone. In contrast to this demand, we identified one hundred and nine critical care beds nationally, and only eight at this institution