title: Incidence of health crises in tourists visiting Jamaica, west indies, 1998 to 2000.
abstract: BACKGROUND
  Tourism is important to the Jamaican economy accounting for approximately 25% of the gross domestic product. Health problems in tourists could have significant impact on the health of the local population, the scarce health service resources, and the tourist industry. This study was conducted to identify health problems most commonly occurring in tourists visiting Jamaica and examine how these problems are managed.
  
  
  METHODS
  Records of health problems occurring in tourists who visited principal tourist areas on the north coast from June 1998 to June 2002 were reviewed for the type of illness and how the problem was handled. The data were analyzed using Epi-Info software (Centers for Disease Control and Prevention, Atlanta, GA) and Statistical Analysis System software (SAS Institute, Cary, NC).
  
  
  RESULTS
  Accidents were the most common health crises reported by tourists. Gastrointestinal, respiratory, and cardiovascular problems occurred less frequently. Those less than 40 years of age more frequently reported accidents or injury, gastrointestinal problems, and drug abuse, whereas respiratory and cardiovascular problems were more common among those above 40 years of age. Cardiovascular problems, drug abuse, and death were more common in men than in women. Hotel nurses handled most of the cases and were more likely to refer patients to private physicians or hospitals than to public hospitals (p <.05). Factors influencing the way the crisis was handled were age (p =.0441); who handled the crisis (p <.0001); and the method of payment (p =.0072). The factors that influenced hospitalization were gender (p =.0615); who handled the crisis at the onset (p =.0497); how the crisis was dealt with (p =.0336); and previous health problems (p =.0056). Men were more likely to be hospitalized and to be referred to a public hospital than women. Medical insurance covered the costs for 11% of tourists, and 75% paid out of pocket.
  
  
  CONCLUSIONS
  The information provided by this study can be used to implement changes to reduce health problems in tourists and improve emergency health services in tourist areas.
authors.affiliation: Department of Epidemiology and International Health, University of Alabama at Birmingham, 1665 University Boulevard, Birmingham, AL 35294-0002, USA.
authors.forename: Danielle T
authors.initials: DT
authors.lastname: Thompson
authors.forename: David V M
authors.initials: DV
authors.lastname: Ashley
authors.forename: Cheryl A
authors.initials: CA
authors.lastname: Dockery-Brown
authors.forename: Alvin
authors.initials: A
authors.lastname: Binns
authors.forename: Curtis M
authors.initials: CM
authors.lastname: Jolly
authors.forename: Pauline E
authors.initials: PE
authors.lastname: Jolly
mesh_terms: D000059:Accidents / Q000706:statistics & numerical data*; D000208:Acute Disease / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006297:Health Services Accessibility; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007563:Jamaica / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014195:Travel