Assessment of Health Services in East Jerusalem: A Cross-Sectional Study

Abstract

Aim: This study aims to evaluate healthcare service delivery and population indicators in East Jerusalem (EJ) for use in health planning, evaluation, and decision-making at both institutional and policy levels. Methods: A mixed-methods approach was adopted. The quantitative component involved a household survey that assessed health conditions and healthcare utilization across 3,747 households, covering 16,433 individuals. The qualitative component included semi-structured interviews with healthcare institution managers. Results: Among children, respiratory illnesses (0.50%) and cardiovascular diseases (0.30%) were the most common. In adults, diabetes (4.32%) and cardiovascular diseases, including hypertension (2.84%), were prevalent. The five hospitals in EJ, with a total of 651 beds, serve residents of EJ, the West Bank, and Gaza. In 2018, EJ hospitals treated over 80,000 inpatients and 240,000 outpatients. The Palestinian Ministry of Health referred 43,256 cases to EJ hospitals, accounting for 40% of all external referrals. Smoking prevalence among adults over 18 was 29.0%. Rehabilitation services were available in 55% of health centers, but mental health services were limited. Around 63% of patients expressed satisfaction with healthcare services, though language barriers and long wait times were issues when referred to Israeli hospitals. Conclusions: EJ hospitals operate near capacity, providing essential tertiary healthcare services and managing substantial referrals from the West Bank and Gaza. Key challenges include long waiting times, high competition among healthcare centers, and shortages in mental health, physiotherapy, and rehabilitation staff. Drug use, particularly in Shu'fat, is a significant social issue. Although patient satisfaction is high, Israeli hospitals are often preferred due to their advanced technologies. There is a clear need to invest in local healthcare centers, improve service quality, and increase specialized care availability, particularly in diagnostics, rehabilitation, and mental health services.