Referrals of Ethiopian Orthopedic Patients for Treatment Abroad.

Background: Referral for treatment abroad has both advantages and disadvantages that need careful balancing at an individual and at a national level. Advances in medical tourism have made referrals easier and currently patient flow is in both directions between developing and developed countries. Training & equipping local surgeons to perform advanced procedures would stop “unnecessary” referrals from developing countries-there by also saving the hard currency which is already compromised. In fact, such a set up in a developing country could be able to receive patients from abroad and generate a foreign currency. The setting for this study was at Addis Ababa University, Faculty of medicine, department of Orthopedics.
Methods: We reviewed the copies of all orthopedic referral papers from the country’s largest tertiary/ teaching Hospital in the whole year 2008.
Results: Only from our department, a total of 115 orthopedic patients were referred for treatment abroad. Most patients were young males from Addis Ababa-the capital. The commonest single diagnosis was osteoarthritis, followed by ACL tear. The top three procedures for which the patients were referred are total hip replacement, ACL reconstruction and total knee replacement. Inter-consultant variation in number of referrals offered was observed. There was no seasonal difference. Over the last five years, we observed an alarmingly increasing trend in the number of abroad referrals.
Conclusion: Total joint replacement and Arthroscopy surgeries are the main reasons to seek for treatment abroad. Sharp and steady increase in number of referrals abroad is observed in the last five years. Different ways to operate these patients inside Ethiopia should be sought.