Article by
Luova Labs

Published on
March 9, 2018

One of the island’s most senior health professionals has revealed that there has been such a “phenomenal” rise in admissions and deaths from kidney failure that the Renal Unit of the Queen Elizabeth Hospital (QEH) can no longer admit new haemodialysis patients unless someone undergoing treatment dies.

Equally troubling, QEH Chief Executive Officer Dr Dexter James said, was the fact that well over half of the kidney patients admitted to the unit die from the disease.

Dr James told a World Kidney Day seminar in the QEH auditorium this morning that the number of new admissions had risen from 110 in 2014 to 117 last year, 69 of whom later died.

The data revealed that while there was a drop in admissions between 2014 and 2015, the death rate continued to soar, with 54 in 2014 and 59 the following year, and 68 of the 105 admitted in 2016.

Chief Executive Officer of the state-run Queen Elizabeth Hospital Dr Dexter James (right) this morning received a donation of ten fully-equipped haemodialysis chairs and an electrocardiography machines from members of the Barbados Public Workers Cooperative Credit Union’s Legacy Foundation.

He also said the cost to the QEH was climbing steadily, raising doubts over whether the health institution would be able to cope.

“In terms of the costs, all 341 patients today cost the Queen Elizabeth Hospital about $19 million per year. This is about 13 per cent of the Queen Elizabeth Hospital budget. At the current rate of growth . . . if the rate continues without any reduction we could see this figure moving to $25 million in the next five years,” Dr James said.

“This is the new normal. This is a phenomenon that has to be addressed because it could have serious implications on whether we as a country, and by extension the Queen Elizabeth Hospital, could sustain this level of growth. And this is only one medical condition. We haven’t talked yet about cancers and the in-patient care,” he added.

Dr James recommended a new multi-pronged plan for the policymakers to urgently consider, including refocusing attention on primary health and an aggressive screening programme where at-risk patients can be identified early and managed at the primary care stage.

“And if we see this phenomenal growth in renal diseases all linked to the NCDs [non-communicable diseases], it means there is some failings, not failure, some failings at our preventative level and we really need to take stock of that,” he stressed.

The senior medical official said the aim was to slow or delay the end-stage of kidney disease, thereby giving health authorities breathing space to take care of patients currently being treated.

Dr James also recommended an expansion in the capacity of the state-owned health facilities to handle renal diseases, along with a multi-disciplinary team that can focus on therapy in cases where patients face death from the disease.

He noted that health care practitioners did not have the time to counsel patients on the need to change their lifestyles.

Therefore, he recommended a model that addresses patients who are in denial, or are angry, depressed, requiring acceptance or want to bargain their treatment options.

“We really now need to have a multi-disciplinary team working with persons who have been diagnosed with kidney problems. Some have social problems, some have psychological problems. So we need a different set up to move someone from the stage of denial, anger and depression to the point where they accept their reality,” he stressed.

Dr James said the hospital needed to look at a short term solution to the rising number of renal patients by issuing an open tender to find out if there were private sector providers willing to set up a plan for these patients.

At today’s seminar, the hospital’s Renal Unit was presented with ten fully equipped dialysis chairs and an electrocardiography (ECG) machine – used to diagnose heart conditions – by the Barbados Public Workers Cooperative Credit Union Legacy Foundation.

Chairperson of the Foundation Maureen Graham said her organization had entered into a three-year strategic partnership with the Barbados Kidney Association to help fight kidney disease.

Barbadostoday.bb Mar 9, 2018