Gavin Reagon

University of the Western Cape, Cape Town, Province of the Western Cape, South Africa

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Publications (8)7.08 Total impact

  • Lebogang Montewa, Lyn Hanmer, Gavin Reagon
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    ABSTRACT: The ability of three procedure coding systems to reflect the procedure concepts extracted from patient records from six hospitals was compared, in order to inform decision making about a procedure coding standard for South Africa. A convenience sample of 126 procedure concepts was extracted from patient records at three level 1 hospitals and three level 2 hospitals. Each procedure concept was coded using ICPC-2, ICD-9-CM, and CCSA-2001. The extent to which each code assigned actually reflected the procedure concept was evaluated (between 'no match' and 'complete match'). For the study sample, CCSA-2001 was found to reflect the procedure concepts most completely, followed by ICD-9-CM and then ICPC-2. In practice, decision making about procedure coding standards would depend on multiple factors in addition to coding accuracy.
    Studies in health technology and informatics 01/2013; 192:1084.
  • Gavin Reagon, Ehimario Igumbor
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    ABSTRACT: The effective functioning of Health Systems is reliant on good quality information being available for decision-making. Routine surveys exemplify an under-utilised source of such information that could enable Health Departments to gain insights into the performance of health service provision, from both the stand-point of the providers and users. Amongst these, Waiting Time and System Efficiency Surveys (WTSES) directly responds to the commonest complaint of users of healthcare services. There is, however, little information on approaches to routinely implement robust and sustainable facility-based WTSES especially in resource-constrained settings. This paper describes the conceptual and methodological basis for implementing WTSES in health care facilities, using a method that places the conduct of the survey within the purview of the normal service activities of health care providers, and thus makes the routine assessment of Waiting Times possible at low cost and with high benefit. The authors aver that the universal implementation of the WTSES presents the potential for enriching patient and health facility information systems, particularly in resource-constrained settings, where efficient use of limited resources is critical.
    Studies in health technology and informatics 01/2010; 160(Pt 1):590-4.
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    ABSTRACT: To investigate the quality of cause of death certification and assess the level of under-reporting of HIV/AIDS as a cause of death at an academic hospital. Cross-sectional descriptive retrospective review of death notification forms (DNFs) of deaths due to natural causes in an academic hospital in Cape Town during 2004. Errors in cause of death certification and ability to code causes of death according to the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) were assessed. The association between serious errors and age, gender, cause of death and hospital ward was analysed. A sample of DNFs (N=243) was assessed for level of under-reporting of HIV/AIDS. A total of 983 death certificates were evaluated. Almost every DNF had a minor error; serious errors were found in 32.2% (95% confidence interval (CI) 29.3-35.1%). Errors increased with patient age, and cause of death was the most important factor associated with serious errors. Compared with neoplasms, which had the lowest error rate, the odds ratios for errors in endocrine and metabolic diseases and genito-urinary diseases were 17.2 (95% CI 8.7-34.0) and 17.3 (95% CI 7.8-38.2), respectively. Based on the sub-sample, the minimum prevalence of HIV among the deceased patients was 15.7% (95% CI 11.1-20.3%) and the under-reporting of deaths due to AIDS was 53.1% (95% CI 35.8-70.4%). Errors were sufficiently serious to affect identification of underlying cause of death in almost a third of the DNFs, confirming the need to improve the quality of medical certification.
    South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde 09/2009; 99(9):648-52. · 1.70 Impact Factor
  • South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde 09/2009; 99(9):643-4. · 1.70 Impact Factor
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    ABSTRACT: To explore alcohol-related practices among general practitioners (GPs) in the Cape Town metropole and to examine barriers to addressing risky drinking among patients. Method: A cross-sectional survey of 50 GPs was conducted between November 2004 and April 2005. A questionnaire assessing GPs' alcohol-related practices and barriers to alcohol-related interventions was administered to participating GPs. In the past 12 months, most GPs reported seeing only 11-30 patients for alcohol problems specifically. While only 12% thought that they could effectively help patients reduce their alcohol consumption, 78% of GPs indicated that, given adequate training and support, they could become more effective. Among the barriers that hindered their ability to intervene in patients' alcohol-related problems were difficulties in getting reimbursed for treating patients with alcohol problems, insufficient training, lack of materials with which to do screening and counselling, perceptions of ineffectiveness, and time constraints. GPs are willing to conduct interventions for risky drinking but require additional training in these interventions as well as appropriate support and intervention tools.
    Scandinavian Journal of Public Health 05/2008; 36(3):298-302. · 1.97 Impact Factor
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    ABSTRACT: While the importance of promoting equity to achieve health is now recognised, the health gap continues to increase globally between and within countries. The description that follows looks at how the Cape Town Equity Gauge initiative, part of the Global Equity Gauge Alliance (GEGA) is endeavouring to tackle this problem.We give an overview of the first phase of our research in which we did an initial assessment of health status and the socio-economic determinants of health across the subdistrict health structures of Cape Town. We then describe two projects from the second phase of our research in which we move from research to action. The first project, the Equity Tools for Managers Project, engages with health managers to develop two tools to address inequity: an Equity Measurement Tool which quantifies inequity in health service provision in financial terms, and a Equity Resource Allocation Tool which advocates for and guides action to rectify inequity in health service provision. The second project, the Water and Sanitation Project, engages with community structures and other sectors to address the problem of diarrhoea in one of the poorest areas in Cape Town through the establishment of a community forum and a pilot study into the acceptability of dry sanitation toilets. A participatory approach was adopted. Both quantitative and qualitative methods were used. The first phase, the collection of measurements across the health subdistricts of Cape Town, used quantitative secondary data to demonstrate the inequities. In the Equity Tools for Managers Project further quantitative work was done, supplemented by qualitative policy analysis to study the constraints to implementing equity. The Water and Sanitation Project was primarily qualitative, using in-depth interviews and focus group discussions. These were used to gain an understanding of the impact of the inequities, in this instance, inadequate sanitation provision. The studies both demonstrate the value of adopting the GEGA approach of research to action, adopting three pillars of assessment and monitoring; advocacy; and community empowerment. In the Equity Tools for Managers Project study, the participation of managers meant that their support for implementation was increased, although the failure to include nurses and communities in the study was noted as a limitation. The development of a community Water and Sanitation Forum to support the Project had some notable successes, but also experienced some difficulties due to lack of capacity in both the community and the municipality. The two very different, but connected projects, demonstrate the value of adopting the GEGA approach, and the importance of involvement of all stakeholders at all stages. The studies also illustrate the potential of a research institution as informed 'outsiders', in influencing policy and practice.
    International Journal for Equity in Health 02/2008; 7:6. · 1.71 Impact Factor
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    ABSTRACT: Letter
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    Vera Scott, David Sanders, Gavin Reagon