This paper analyses data for 1990 culled from the medical recordas of
the Queen Elizabeth Hospital, Barbados and examines the use of inpatie
nt and amergency services by visitors to Barbados. The 473 visitors ad
mitted represented 2.1% of all admissions. The records of 425 containe
d information on country of origin: 145 were from non-Caribbean and 28
0 from Caribbean countries. The distribution by country of non-Caribbe
an visitors was the same as that of regular tourist arrivals - the maj
ority came from the USA. Canada and the UK. Caribbean visitors represe
nted 14.4% of the tourists, but accounted for 65.9% of visitor admissi
ons. Non-Caribbean visitors wsere 85.6% of tourists, but 34.1% of admi
ssions. Young patients predominated among Caribbean, and older patient
s among non-Caribbean. Accidents, cardiovascular disease, alcohol-rela
ted illnesses and near drowning were commoner in the non-Caribbean vis
itors, while cancer and obstetrical/gynaecological problems were commo
ner in Caribbean visitors. Seven per cent of visitor admissions went t
o the Intensive Care Unit as against 0.15% of other patients. The aver
age hospital stay of visitors was 11.7 days compared with 7.0 days for
Barbadians. There were 898 visitors treated in the Accident and Emerg
ency Department and the commonest problems were lacerations, abrasions
and infections. The UK provided most of these patients. These data sh
ow that there is appreciable visitor use of the public health services
. Non-Caribbean visitors use them because they fall ill on holiday, bu
t many Caribbean visitors may come specifically for health care. The c
ost to the Barbadian health service is not insignificant: at the 1990
estimated bed-day cost of Bds$250, it represents a cost of Bds$1.1 mil
lion per annum to the Government for inpatient services alone, or 2% o
f total hospital costs.