Abstract:
South Africa has recorded the highest COVID-19 morbidity and mortality compared to
other African regions. Several authors have linked the least amount of death in African countries
with under-reporting due to poor health systems and patients’ health-seeking behaviors, making the
use of clinical audits more relevant for establishing the root causes of health problems, and improving
quality patient care outcomes. Clinical audits, such as mortality audits, have a significant role in
improving quality health care services, but very little is documented about the outcomes of the
audits. Therefore, the study sought to determine the health care system and patient-related factors
associated with COVID-19 mortality by reviewing the COVID-19 inpatient mortality audit narration
reports. This was a retrospective qualitative research approach of all hospitalized COVID-19 patients,
resulting in death between the first and second COVID-19 pandemic waves. Thematic analysis
employed inductive coding to identify themes from mortality audits from all 41 public hospitals in
Limpopo Province, South Africa. Four themes with seventeen sub-themes emerged: sub-standard
emergency medical care provided, referral system inefficiencies contributed to delays in access to
health care services, the advanced age of patients with known and unknown comorbidities, and
poor management of medical supplies and equipment, as a health system and patient-related factors
that contributed to the high mortality of COVID-19 patients. There is a need to routinely conduct
clinical audits to identify clinical challenges and make recommendations for health promotion, risk
communication, and community engagement. We recommend reviewing and expanding the scope
of practice for health-care providers during epidemics and pandemics that include aspects such as
task-shifting.
Description:
Journal article published in the journal of Healthcare, 2022, 10, 1388
