Immigrating to a universal health care system: utilization of hospital services by immigrants in Israel

Abstract

Background: During the 1990s, Israel absorbed approximately 1 million immigrants. The entitlement to citizenship and social rights in a country with universal health care coverage makes the Israeli case of special interest concerning immigrants' utilization of health care services.

Objectives: 1. To describe utilization patterns of emergency room and in-hospital services among recent immigrants to Israel. 2. To determine if and when there is convergence of health care utilization patterns on the part of recent immigrants with native-born and long-established immigrants to Israel.

Methods: Data was obtained from Clalit Health Services computerized database and included sociodemographics, date of immigration,presence of chronic disease, emergency room visits, and hospitalization days among all covered residents.Descriptive analysis of the group characteristics, multivariate analyses to determine influential factors, and tests for trend were conducted.

Results: Rates of emergency room and hospitalization were lower for immigrants, and remained so even after 10 years.

Conclusions: Economic and cultural factors influence health care utilization among immigrants and may lead to inequity in health care delivery and consequent health outcomes. A better understanding is needed for the differences in health care utilization patterns between immigrants and veteran Israelis.