Department of Trauma and Orthopaedics, Ninewells Hospital, Dundee, DD2 1SG, Scotland, UK.
Department of Trauma and Orthopaedics, Ninewells Hospital, Dundee, DD2 1SG, Scotland, UK.
Surgeon. 2021 Jun;19(3):162-166. doi: 10.1016/j.surge.2020.06.003. Epub 2020 Jul 7.
NHS Highland covers a wide geographical region encompassing the Isle of Skye, and Ben Nevis. Tourism is a significant contributor to the local economy and in 2017 the Highlands welcomed 534,000 visitors. Health services across the region treat tourists in addition to the local population. We investigated how many tourists accessed the Trauma and Orthopaedic (T&O) Department at Raigmore Hospital, Inverness.
We conducted a cross-sectional study with data collected over one year (2017). The number of tourists referred to T&O including patient demographics, country of origin, type of injury and their clinical outcome were recorded. A freedom of information (FOI) request to NHS Highland was sought to investigate associated costs incurred by tourists.
376 tourists accessed T&O services in 2017. Country of origin: 47 (12.5%) Scotland; 177 (47.1%) rest of UK; 74 (19.7%) EU; 45 (12.0%) non-EU. Highest referral month August (61), lowest referral month November (8). Injuries: 224 (59.6%) fracture; 62 (16.5%) soft tissue injury; 20 (5.3%) laceration. Commonest sites of injury were ankle, distal radius and finger.
28 (7.4%) Virtual clinic; 137 (36.4%) hospital admission; 193 (51.3%) advice to referring team and discharge; 13 (3.5%) direct discharge by T&O; 4 (1.1%) missing. No. of trauma cases booked: tourists 133 (9%), local population 1415 (91%).
Tourists account for fewer than ten percent of the T&O surgical workload over one year with common injuries being fractures affecting the extremities. Seasonal variation was observed with more referrals occurring in the summer months. Just under half of tourists originated from outside the UK and EU. Health boards should consider increasing resources over the summer months to deal with expected increases in tourist numbers and should be able to recover the cost of treatment from the patient or their travel insurance companies directly at point of care.
NHS 高地涵盖了一个广阔的地理区域，包括斯凯岛和本尼维斯山。旅游业是当地经济的重要贡献者，2017 年，高地迎来了 53.4 万名游客。该地区的卫生服务机构除了为当地居民提供服务外，还为游客提供服务。我们调查了有多少游客在因弗内斯的 Raigmore 医院的创伤和骨科（T&O）部门就诊。
我们进行了一项为期一年（2017 年）的横断面研究。记录了转诊至 T&O 的游客人数，包括患者人口统计学特征、原籍国、受伤类型和临床结果。我们向 NHS 高地提出了一项信息自由（FOI）请求，以调查游客产生的相关费用。
2017 年有 376 名游客使用了 T&O 服务。原籍国：47 名（12.5%）苏格兰；177 名（47.1%）英国其他地区；74 名（19.7%）欧盟；45 名（12.0%）非欧盟。就诊人数最多的月份是 8 月（61 人），就诊人数最少的月份是 11 月（8 人）。受伤类型：224 名（59.6%）骨折；62 名（16.5%）软组织损伤；20 名（5.3%）撕裂伤。最常见的受伤部位是踝关节、桡骨远端和手指。
28 名（7.4%）虚拟诊所；137 名（36.4%）住院治疗；193 名（51.3%）向转诊团队提供建议并出院；13 名（3.5%）T&O 直接出院；4 名（1.1%）失踪。预约的创伤病例数：游客 133 例（9%），当地居民 1415 例（91%）。
在一年的时间里，游客仅占 T&O 手术工作量的不到 10%，常见的受伤类型是影响四肢的骨折。观察到季节性变化，夏季就诊人数较多。近一半的游客来自英国和欧盟以外的国家。卫生委员会应该考虑在夏季增加资源，以应对游客人数的预期增加，并且应该能够直接在护理点从患者或其旅行保险公司收回治疗费用。
