Higher Rates of Hospitalizations among Pediatric Refugees than Local Population Attending the Emergency Department and Longer In-patient Stay.

BACKGROUND

The global refugee crises have raised concerns among medical communities worldwide; nonetheless, access to healthcare has rarely been studied even though refugees are a medically high-risk group.

OBJECTIVES

To compare pediatric department admission rates from the pediatric emergency department (PED) of refugees and Israelis.

METHODS

We compared data from refugee and Israeli children admitted to the pediatric department at Wolfson Medical Center in Israel between 2013-2017.

RESULTS

A total of 104,244 patients (aged 0-18 years) came to the PED. Admission rate to the pediatric department for refugees was 695/2541 (27%) compared to 11,858/101,703 (11.7%) Israeli patients (P < 0.001). Hospital stay for patients 0-2-years of age was 3.22 ± 4.80 days for refugees vs. 2.78 ± 3.17 for Israelis (P < 0.03). Re-admission rate within 7 days was 1.3% for refugees and 2.6% for Israelis (P < 0.05). Dermatological diseases (e.g., impetigo and cellulitis) were more frequent in refugees (23.30% vs. 13.15%, P < 0.01); however, acute gastroenteritis and respiratory diagnoses were more common in Israelis (18.52% vs. 11.72%, P < 0.05 and 14.84% vs. 6.26%, P < 0.01, respectively). Neurological diseases (e.g., febrile convulsions) were also more frequent in Israelis (7.7% vs. 3%, P < 0.05). Very significantly, 23% of refugees had no healthcare coverage, while only 0.2% of the Israelis had none (P < 0.001).

CONCLUSIONS

We found significant morbidity in refugees compared to the local Israeli pediatric population, highlighting the need for different approaches for each population.