Neurological/neurosurgical referrals from Queen Elizabeth Hospital, Barbados - abstract

ABSTRACT

Neurological/neurosurgical cases (NNC) requiring overseas investigation and treatment have become an increasingly difficult problem for Barbados in recent years. All overseas referrals from Queen Elizabeth Hospital (QEH) between January 1, 1984 and November 1, 1987 have been reviewed. Ninety one NNCs were referred; there were 48 males and 43 females, aged 32ñ7 years (meanñSD, range 4 months to 69 years). Only five were older than 60 years. Eleven centres were used. In 1984 referrals to the University Hospital of the West Indies (UHWI), Jamaica, ceased; for the next two years, most NNCs were sent to Port-of-Spain, Trinidad. Several factors, chiefly bureaucratic delays in approval for transfer, forced new lines of referral, outside of the Caribbean. In 1986 and 1987, 63 percent of new cases were referred to North America, chiefly to Mount Sinai Hospital New York. This was made possible by a Government aid scheme. During 1984 - 1986, there were non-surgical than surgical cases. In January 1987, a CAT Scan was installed at QEH and there was a marked fall (by over 60 percent) in referrals in 1987. Each of the 13 NNCs referred in this year was correctly diagnosed as needing surgery. This represents a huge savings in non-surgical referrals for investigation. Lack of neurological/neurosurgical facilities for investigation and treatment has placed an inordinate burden on finances, social services and internists, as well as severely compromising the outcome of NNCs (AU)