Online Program

Acceptability of emergency surgical care in the private and public sectors of Cape Town, South Africa

Monday, November 2, 2015

Estin Yang, MD, MPH, Department of Surgery, Oregon Health & Science University, Portland, OR
Delawir Kahn, MBChB, ChM, FCS(SA), Department of Surgery, University of Cape Town, Observatory, South Africa
Colin Cook, MBChB, FCOphth(SA), FRCOphth, MPH, Division of Ophthalmology, University of Cape Town, Observatory, South Africa

We compared patient satisfaction and attitudes toward emergency surgical care received in public and private sector hospitals in Cape Town, South Africa.


From September 2013 to March 2014, we conducted in-depth interviews on adult patients undergoing appendectomy for acute appendicitis at two public and three private hospitals in the Cape Town metropole.  Patients were interviewed during the initial hospitalization and again upon returning home.


Patient satisfaction toward the care received was similar between the two groups, with patients feeling well prepared to transition home at discharge and treated respectfully by health care workers during their stay.  Surgeons in both sectors communicated well with patients.  However, public sector patients tended to consider the absence of negative events as satisfactory, whereas private sector patients emphasized positive and exemplary care as markers for adequacy, suggesting a discrepancy in baseline expectations.  Furthermore, perceived attitudes of health care workers were often influenced by interactions of ethnicity and race.           


In spite of commonly presumed discrepancies of care provided at public and private hospitals, patients in both sectors  were overall satisfied with the care received.  However, disparate expectations between the two groups informed what was perceived to be satisfactory and respectful.  Ethnic differences among patients and health care workers also influenced the acceptability of the care.  Further studies interpreting the patient experience in South Africa’s private and public sectors should take into account the implications of baseline expectations of patients, incorporating the significance of racial and cultural interactions on the acceptability of care.

Learning Areas:

Clinical medicine applied in public health
Diversity and culture
Provision of health care to the public
Public health or related research

Learning Objectives:
Compare public and private emergency surgical care delivery in South Africa. Identify influencing factors for patient satisfaction in private and public hospitals in South Africa.

Keyword(s): Health Care Access, Patient Satisfaction

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a resident physician in Surgery and studied public health at the University of Cape Town, South Africa, with published clinical research focused on disparities of care for surgical patients in the private and public sectors.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3106.0: Poster Session 6