Ukrainian refugees healthcare resource utilization in Israel

Limor Adler, Eugene Merzon, Bar Cohen, Pavlo Kolesnyk, Shlomo Vinker

Keywords: Ukranian refugees, healthcare resource utilization, primary care

Background:

Since February 2022, when the Russians invaded Ukraine and started the Russia-Ukraine war, many Ukrainians left their homes in search of safety. Israel accepted more than 14,000 Ukrainian refugees.

Research questions:

The aim of this study was to evaluate healthcare resource utilization of Ukrainian refugees and compare it to matched Israeli individuals.

Method:

In this retrospective cohort study we extracted all files from the electronical medical records of Leumit Healthcare Services (LHS). LHS insures all Ukrainian refugees 60 years or older. We than matched for each Ukrainian refugee, Israeli individuals based on age, sex and country of origin (individuals who were born in the former Soviet Union). We compared healthcare resource utilization with Poisson regression for count variables.

Results:

Among the refugee group, the mean age was 71.4 (± 7.095) and the majority were females (77.37%). Compared to their matched controls, the refugees were much less likely to have mail and video visits to the doctor (IRR = 0.457 and 0.329, respectively, p-value=0.00), and somewhat less likely to have a phone or regular visit (IRR = 0.838 and 0.888, respectively, p-value=0.00). Across all but one specialty recorded in this study, refugees were less likely to have a consultation with a specialist (urogynecology, endocrinology, gastroenterology, general surgery , orthopedic surgery, dermatology, ophthalmology neurology and psychiatry; IRR=0.800, 0.485, 0.529, 0.542, 0.607, 0.352, 0.592, 0.716, 0.315, p-value=0.00). The only exception is a consultation with a cardiologist (IRR=1.209, p-value=0.011). Additionally, refugees had fewer emergency room visits (IRR=0.424 , p-value=0.00), fewer hospitalizations (IRR=0.545 , p-value=0.00), shorter hospitalizations on average (IRR=0.488 , p-value=0.00), fewer referrals for dialysis (IRR=0.164 , p-value=0.00) and for surgery (IRR=0.614 , p-value=0.00).

Conclusions:

Ukrainian refugees have fewer visits to primary care consultations, emergency department visits and hospitalizations. To better understand the reasons for these findings, another research with a different study design should conducted.

Points for discussion:

Ukrainian refugees has lower rates of usages of healthcare resource utilization.

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