PP 96 THE MODE AND LOAD OF REFERRAL FOR THE “ISLAND” WITHIN AN ISLAND: A REVIEW

Abstract

INTRODUCTION

Kapit Hospital serves as the only hospital in the division of Kapit, Sarawak, covers three districts (Kapit, Song and Belaga) and two sub-districts (Nanga Merit and Sungai Asap). It is the only hospital that not connected by road to the nearest referral center. The main mode of referral is by boat and air MEDEVAC.

METHOD

This paper reviews the load and mode of cases referred to Sibu or Sarawak General Hospital. It is a retrospective study of data collected in year 2015. REVIEW The total cases referred were 1083 cases, with an average of 90.25 cases per month. The outpatient referral takes up 61.6% (667 cases), while in patient referral 38.4% (416 cases). Cases for imaging purposes 26.4% (286 cases), with the highest referral load is Ultrasonography 12.8% (139 cases), followed by Computed Tomography Imaging 10.7% (116 cases).The department with the highest referral load was Medical (38.4%, 416 cases), followed by Surgical (23.9%, 259 cases). The mode of transport using express boat is 1052 cases (97.1%), followed by the ambulance boat usage (1.8%, 20 cases), MEDEVAC (1.0%, 11 cases) and MAS fixed wings (0.6%, 7 cases).

DISCUSSION

Escorting referral cases is an integral part of Kapit Hospital staff’s duty as reflected by the total number of 824 cases (76.1%) requiring medical escorts. This put a heavy burden not only on the hospital’s manpower, but also the hospital expenditure. All the modes of transfer carry different advantages and disadvantages, wisely choosing the mode of transfer are a must to learn skill. Good patient packaging and preparation for long journey of transfer is essential to achieve quality transfer. It ensures better continuity of patient care and safety of the staff on escorting missions.