Surge capacity of the curative sector healthcare institutions for the management of Dengue in Kurunegala district, Sri Lanka

Abstract

Background: Surge capacity is defined as the ability to obtain adequate staff, supplies, structures and systems to provide sufficient care to meet immediate needs of an influx of patients. The aim of the study was to describe surge-capacity of the curative-healthcare institutions for the management of dengue in Kurunegala district. Methods: A descriptive cross-sectional study was conducted among all curative-healthcare institutions with inward-care (n=46), May-September 2019. The data was taken from the medical administrator or designated person using an interview administered tool, which was formulated using 'Science of Surge Theory' and 'CO-S-TR Model'. Results: Response-rate was 93.5% (n=43). The higher proportion had inadequate staff capacity (55.8%; n=24), adjustable beds (69.8%; n=30), infusion-pumps (72.1%; n=31), monitors (51.2%; n=22), oxygen (100%; n=43) and 27.9% (n=12) had Pack-Cell-Volume (PCV) monitors. Of the equipped institutions, 13.3% (n=4), 38.7% (n=12), 40.9% (n=9), 30.2% (n=13) and 66.7% (n=8) had adequate number of adjustable beds, infusion-pumps, monitors, oxygen and PCV-monitors respectively. The majority had designated emergency units (90.7%; n=39) and 11.6% (n=5) X-ray, 9.3% (n=4) USS and 9.3% (n=4) blood bank. The majority had focal-points (76.7%; n=33), written disaster plans (72.1%; n=31) and 34.9% (n=15) had teams with adequate risk-communication capabilities. The higher proportion (69.8%; n=30) had inadequate overall surge capacity. The Provincial General Hospitals and 75% (n=3) of the Base-hospitals had moderate-level and 76.3% (n=29) of the District-Hospitals had basic-level overall surge capacity for dengue outbreak management. Conclusion: There is a need for improvement of surge capacity of the curative-healthcare institutions and capacity development programmes need to be initiated.