Pediatric Refugees Require More Hospitalizations and Longer in-Patient Stay than the Local Population

Abstract

Background: The ongoing global refugee crises have raised concerns among medical communities worldwide.Methods: We compared data from refugee and Israeli children admitted to the pediatric department (PD) at Wolfson hospital in Israel, between 2013–2017.Results: 104,244 visits (0–18 years) to the pediatric emergency department (PED) were recorded. Admission rate to the PD for refugees was 695/2541 (27%) as compared to 11,858/101,703 (11.7%) for Israeli patients (P < 0.001). After matching for age groups (0–5 years), the hospital stay duration for the 0–2 years age was 3.22 (± 4.80) days for the refugees and 2.78 (± 3.17) for the local population (P < 0.03). For 0–2 year old children, re-admission rates within 7 days, were 1.3% for refugees and 2.6% for Israelis, (p < 0.05). Dermatological diseases (mainly 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 Israeli children (11.72% vs. 18.52%, p < 0.05 and 6.26% vs. 14.84%, p < 0.01, respectively). Neurological diseases (mainly febrile convulsions) were also more frequent in Israeli patients (7.7% vs. 3%, P < 0.05). Very significantly, 23% of refugees had no health care coverage, while only 0.2% of the Israeli patients had no medical coverage (P < 0.001).Conclusion: We found evidence for significant morbidity in refugees as compared to the local Israeli pediatric population, highlighting the need for tailoring different approaches to this fragile population.Key notes· The subject of refugees’ access to health care has been scantly studied so far even though refugees are considered to be a medically high-risk group.· The results indicated a higher rate of hospitalization and morbidity in refugee patients.· These findings highlight the need to tailor a specific approach to treating this population.