USE BY VISITORS OF THE SERVICES OF THE QUEEN ELIZABETH HOSPITAL, BARBADOS, WI

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.