Care and Youth Caribbean Netherlands (Zorg en Jeugd Caribisch Nederland, ZJCN) is publishing an overview of the number of medical referrals in the period between 2020 and 2025. Medical referrals take place when people insured for specialist care or diagnostics need treatment outside Bonaire, St. Eustatius or Saba. The figures provide an insight into trends over a number of years, the places patients come from and the most common referrals per specialism.
The number of medical referrals is partly dependent on the specialist care available on Bonaire, St. Eustatius and Saba. If treatment cannot be provided locally, ZJCN refers policyholders to regional care partners elsewhere in the Caribbean. At the moment ZJCN has contracts with care providers on St. Maarten, Curaçao and Aruba and in Colombia and the Netherlands.
Changes in the number of referrals between 2020 and 2025
Following the coronavirus pandemic the number of medical referrals rose gradually in 2020–2022 as travel restrictions were scaled back and 2023 was a peak year, with a total of 7,088 medical referrals from the Caribbean Netherlands. In that same year the proportion of non-emergency forms of treatment was relatively high, at 25% compared to the average of 7% in the other years.
In 2024 and 2025 the total number of referrals stayed reasonably stable, at just under 7,000. A slight increase occurred in 2025 compared to the previous year (from 6,787 to 6,971).
Medical Referrals 2020-2025
Age and sex
Almost half of all the people who were referred in the period from 2020 to 2025 were between 40 and 65 years old. Slightly more women than men were referred in all years, with their share in total being between 51% and 57%.
Origin per island
The largest number of referred patients came from St. Eustatius. This was primarily due to the number of referrals for kidney dialysis. On St. Eustatius and Saba the number of referrals during the past two years has increased, while the opposite is the case on Bonaire.
Referral destinations
Most of the referrals made from Saba and St. Eustatius were for medical care on St. Maarten. The majority of people referred from Bonaire were sent to Curaçao and Aruba. In a few cases referrals were also made to other countries or specialist centres, depending on the treatment required and the availability of care.
Medical referrals from Bonaire 2025-2025
Per destination
Medical referrals from Saba 2020-2025
Per destination
Medical referrals from Statia 2020-2025
Per destination
The most common referrals per specialism
By far the majority of the people were referred for radiology-related treatment.
Relatively speaking the number of referrals for gynaecology, surgery and internal medicine treatment was higher in 2020 than in other years.
Medical referrals per specialism 2020-2025
Monitoring and follow-up
ZJCN is going to continue monitoring the number of medical referrals on a monthly basis and will publish the relevant data at https://english.zorgenjeugdcn.nl/healthcare/medical-referral/medical-referrals-facts--figures. The organisation will use the insights gained to develop policy and improve cooperation with care providers, at both local and regional level.