BMJ  2006;332:1122-1124 (13 May), doi:10.1136/bmj.38793.695081.AE (published 3 April 2006)

Research

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

Maren Johanne Heilskov Rytter, medical student1, Anne-Lene Kjældgaard, medical student1, Henrik Brønnum-Hansen, senior researcher1, Karin Helweg-Larsen, senior researcher1

1 National Institute of Public Health, Øster Farimagsgade 5A, 1399 DK, Copenhagen, Denmark

Correspondence to: K Helweg-Larsen khl{at}niph.dk

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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This article has been cited by other articles:

  • Thaler, L. (2006). Access to emergency care in Palestinian West Bank: Methods were incomplete.. BMJ 332: 1276-1276 [Full text]  
  • Brown, E. (2006). Access to emergency care in Palestinian West Bank: study seems not to have been critically appraised.. BMJ 332: 1275-1276 [Full text]  
  • Richter, E. D, Blum, R., Rivkind, A. (2006). Access to emergency care in Palestinian West Bank: interpretation of results is flawed.. BMJ 332: 1276-1276 [Full text]  

Rapid Responses:

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Palestinian Authority cannot be absolved from healthcare issues
David M Lewis
bmj.com, 27 Apr 2006 [Full text]
Comment on Rytter, et al: “Effects of armed conflict on access to emergency health care in Palestinian West Bank:” - BMJ online April 3 2006
Elihu D Richter, et al.
bmj.com, 15 Apr 2006 [Full text]
Questions for the authors
Daniel Y Ellis
bmj.com, 27 Apr 2006 [Full text]
A regrettable decision made by the BMJ to publish this
Richard L. Dressler
bmj.com, 13 May 2006 [Full text]
serious methodological flaws - inconclusive results
Limor Aharonson-Daniel, et al.
bmj.com, 14 May 2006 [Full text]
Rapid response
Munjed F Al Qutob
bmj.com, 16 May 2006 [Full text]
Comments from a virtual reviewer
Avihu Boneh
bmj.com, 16 May 2006 [Full text]
Irresponsible Publication
Herbert B. Hechtman
bmj.com, 17 May 2006 [Full text]
The situation in the West Bank- Who is really to blame?
Avrum G Jacobs
bmj.com, 18 May 2006 [Full text]
Egregious breakdown of peer review
Barry P Markovitz
bmj.com, 18 May 2006 [Full text]
Compliance with BMJ guidelines for authors
Seymour H Codish
bmj.com, 18 May 2006 [Full text]
Do higher hospital admission rates mean more severe medical conditions?
Basil Porter
bmj.com, 18 May 2006 [Full text]
Re: Irresponsible Publication
nigel de kare-silver
bmj.com, 18 May 2006 [Full text]
Palestinian collective punishment
Phillip Moradi
bmj.com, 19 May 2006 [Full text]
Flawed science with political bias
Robert L. Berger
bmj.com, 26 May 2006 [Full text]
Response
Derek A Summerfield
bmj.com, 22 May 2006 [Full text]
Editorial Misconduct due to 'erroneous' publication ?
Dr Jonathan Hasleton
bmj.com, 25 May 2006 [Full text]
Palestinian and UN ambulances
derek a summerfield
bmj.com, 26 May 2006 [Full text]
Re: Editorial Misconduct due to 'erroneous' publication ? - Editor's reply
Fiona Godlee
bmj.com, 25 May 2006 [Full text]
Re: Editorial Misconduct due to 'erroneous' publication ? - Reply to the Editor
Dr Jonathan Hasleton
bmj.com, 26 May 2006 [Full text]
International Politics and the BMJ - Questions for the Editor
Professor Philip Hasleton
bmj.com, 26 May 2006 [Full text]
Re: Palestinian and UN ambulances - The abuse of...
Dr Jonathan Hasleton
bmj.com, 26 May 2006 [Full text]
The mythical myth?
Daniel Ellis
bmj.com, 30 May 2006 [Full text]
Comment on Rytter, et al: “Effects of armed conflict on access to emergency health care in Palestinian West Bank:” BMJ 13 May 2006
Marc Gotkine, et al.
bmj.com, 30 May 2006 [Full text]
Effect of conflict in Palestine
Azhar Ali
bmj.com, 3 Jun 2006 [Full text]
Ambulances: a comparison of cited sources
derek a summerfield
bmj.com, 1 Jun 2006 [Full text]
Authors' reply
Karin Helweg-Larsen, et al.
bmj.com, 2 Jun 2006 [Full text]
Re: Authors' reply
Dr Jonathan Hasleton
bmj.com, 9 Jun 2006 [Full text]
A genuine paper by Drs Rytter and colleagues
Munir E Nassar
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