Effects of armed conflict on access to emergency health care in Palestinian West Bank: systematic collection of data in emergency departments

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Abstract
Objective To assess the impact of restrictions in access to hospital services imposed on the civilian population during the armed conflict in the Palestinian territories occupied by Israel. Design Consecutive registration of demographic and medical data, with information about transportation time, delay in access to hospital, and course of hospital contact. Setting Three hospital emergency departments in Bethlehem and Nablus, in the occupied Palestinian West Bank, during one week in each hospital. Participants All patients seeking health care in the three hospitals during the study period. Results A total of 394 of the 2228 emergency department contacts reported being delayed at checkpoints or by detours on their way to the emergency department. Hospital admission was significantly more common for these patients: 32% (n = 125) compared with 13% (n = 205) among those who were not delayed. Conclusion 18% of the emergency department contacts were delayed because of the occupation. The higher hospital admission rate in this group suggests that restrictions in access to hospital services influence the severity of the medical conditions presented.

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