Effect of the 2014 attack on Gaza on the use of medical services in Al-Nasser Pediatric Hospital: a comparative study

Abstract

BackgroundDuring the 51-day attack on Gaza in 2014, approximately 2145 people were killed, of whom 20% were children. This study was done to evaluate the use of medical services in Al-Nasser Paediatric Hospital during the attack. MethodsWe retrospectively compared the number and pattern of admissions to Al-Nasser Paediatric Hospital, the largest paediatric hospital in Gaza Strip, during the period of attacks in July to August, 2014, with those during July to August in 2013. Data were obtained from the patients’ medical records. Findings3018 patients were admitted during the 2014 attacks and 1706 during the corresponding period in 2013. There were no significant differences in sex (male: 60·6% in 2014 vs 59·4% in 2013) and geographical distribution (children from Gaza: 75·6% in 2014 vs 78·1% in 2013; North-governorate: 17·8% vs 18·8%) of the patients between the two periods. Moreover, there were no significant differences in the distribution of different disease categories, except for that of meningitis (43·2% in 2014 vs 21·9% in 2013; odds ratio [OR] 2·7, 95% CI 2·2–3·3). Number of emergency room visits (20 100 patients in 2014 and 20 400 in 2013) and hospital mortality rate (1·2% in 2014 and 1·3% in 2013) were similar in the two periods. Bed occupancy rate nearly doubled during the attack period (180% vs 95%; OR 1·9, 95% CI 1·3–2·7]). The median hospital stay was significantly shortened during the attack period (2 [IQR 1–3] days vs 3 [1–6] days; difference in means 0·67, 95% CI 0·65–0·68). InterpretationThe admission rate during the attack period was increased, without a significant increase in emergency room visits. This finding could be due to the closure of other health-care facilities (because of damage or insecurity), but also might be attributable to changes in health-care seeking behaviour during the attack period because only patients who are severely ill take the risk to come to the emergency department; this behaviour could be reflected by the increase in meningitis-related admissions during the attacks. Despite the increase in admission and bed-occupancy rate during the attack period, hospital mortality rates were similar in both periods. Required resources (including human workforce) should be prepared in advance to accommodate the increase in admission rate during emergency state. FundingNone.