Original Research

A retrospective review of speech-language therapy services provided to adult inpatients at a central-level hospital in Gauteng, South Africa

Jennifer Stone, Azra Hoosen, Hayley Hochfelden, Innocent Maposa, Shajila Singh
South African Journal of Communication Disorders | Vol 67, No 1 | a707 | DOI: https://doi.org/10.4102/sajcd.v67i1.707 | © 2020 Jennifer Stone, Azra Hoosen, Hayley Hochfelden, Innocent Maposa, Shajila Singh | This work is licensed under CC Attribution 4.0
Submitted: 27 March 2020 | Published: 26 November 2020

About the author(s)

Jennifer Stone, Department of Speech Therapy and Audiology, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa
Azra Hoosen, Department of Speech Therapy and Audiology, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa
Hayley Hochfelden, Department of Speech Therapy and Audiology, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa
Innocent Maposa, Division of Epidemiology and Biostatistics, University of the Witwatersrand, Johannesburg, South Africa
Shajila Singh, Department of Communication Sciences and Disorders, University of Cape Town, Cape Town, South Africa


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Abstract

Background: The quadruple burden of disease (BoD) and multimorbidity reflected in South Africa’s public health sector challenges speech-language therapists (SLTs) to optimise patient management in this context. For planning and delivery of appropriate services, it is important to understand the profile of speech-language therapy (SLT) patients and the public healthcare services provided by SLTs.

Objectives: This study aimed to describe the prevalence of inpatient adult speech, language and swallowing disorders associated with various medical conditions and South Africa’s BoD, in addition to the target areas and duration of SLT interventions provided at a central public hospital.

Method: A retrospective review was conducted on records of 2549 adult inpatients who received SLT services between January 2014 and December 2015 at Chris Hani Baragwanath Academic Hospital. Data, including demographics, medical and SLT diagnoses, and treatment recommendations, were analysed using descriptive and inferential statistics.

Results: Non-communicable diseases (NCDs) were most prevalent (77.48%), with multimorbidity of BoD categories in 29.27% of patients. Cerebrovascular disease (CeVD) comprised 52.45% patients, with CeVD, traumatic brain injury, other neurological conditions, cancer and burns comprising 88.74% patients. More than a third of the patients with CeVD were < 56 years (n = 486; 36.35%). Dysphagia (48.96%), aphasia (30.95%) and dysarthria (23.62%) were the most common, with 44.68% of patients having multiple SLT diagnoses. The number of SLT sessions significantly correlated with SLT comorbidity (rs = 0.4200; p = 0.0000), but not BoD comorbidity (rs = 0.0049; p = 0.8058).

Conclusion: Speech-language therapy patients reflected a heavy NCD burden and multimorbidity. Provision of SLT services should take into consideration a profile of increased complexity of medical conditions and SLT diagnoses.


Keywords

speech-language therapy; dysphagia; aphasia; dysarthria; intervention; burden of disease; multimorbidity; public healthcare.

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