title: Primary Care in Extreme Environments: Medical Clinic Utilization at Antarctic Stations, 2013-2014.
abstract: OBJECTIVE
  The unique challenges posed by the Antarctic environment include both physiological and psychological stressors to the individual as well as the limited onsite medical capabilities available to address them. This report compares medical clinic utilization among 3 US Antarctic stations to identify differences in diagnostic frequency and utilization of clinic resources under current medical prescreening regimes for summer and winter seasons.
  
  
  METHODS
  Clinic data from 3 Antarctic locations (McMurdo Station, Amundsen-Scott South Pole Station, and Palmer Station) for the 2013-2014 Antarctic year were reviewed for patient encounter frequency by season, and provider-assigned visit diagnostic category. Differences between relative diagnosis frequencies among stations were analyzed, and per-capita clinic utilization was compared.
  
  
  RESULTS
  The McMurdo clinic recorded 1555 patient encounters, with South Pole Station reporting 744 and Palmer with 128 encounters over the year. The most frequent reasons for clinic visits were orthopedic and dermatologic, with increased visits at McMurdo for respiratory illness and at the more remote locations for neurologic complaints and insomnia. Altitude-related visits were reported only at McMurdo and South Pole stations.
  
  
  CONCLUSIONS
  The clinic volume predictably correlated with station population. Insomnia and headache complaints, reported only at the South Pole Station, are likely associated with the increased elevation at that site, although they could be attributable to psychological stress from the isolated environment. Although the majority of cases could not be prevented with current screening, we suggest several changes to the current concept of operations that may decrease medical utilization and provide significant improvements to health care delivery on the ice.
authors.affiliation: University of Texas Medical Branch, Department of Preventive Medicine and Community Health, Galveston, Texas (Dr Pattarini). Electronic address: james.pattarini@utmb.edu.
authors.forename: James M
authors.initials: JM
authors.lastname: Pattarini
authors.affiliation: University of Texas Medical Branch, Center for Polar Medical Operations, Galveston, Texas (Ms Scarborough; Mr Sombito; and Dr Parazynski).
authors.forename: Jullian R
authors.initials: JR
authors.lastname: Scarborough
authors.affiliation: University of Texas Medical Branch, Center for Polar Medical Operations, Galveston, Texas (Ms Scarborough; Mr Sombito; and Dr Parazynski).
authors.forename: V
authors.initials: V
authors.lastname: Lee Sombito
authors.affiliation: University of Texas Medical Branch, Center for Polar Medical Operations, Galveston, Texas (Ms Scarborough; Mr Sombito; and Dr Parazynski).
authors.forename: Scott E
authors.initials: SE
authors.lastname: Parazynski
mesh_terms: D000864:Antarctic Regions; D000071251:Extreme Environments; D006801:Humans; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012621:Seasons
keywords: Antarctica; MEDEVAC; South Pole; altitude sickness; austere environment; isolation; remote environment