Varied utilisation of health provision by Arab and Jewish residents in Israel

International Journal for Equity in Health

Research Article

Jo Southern¹  Aviva Goral²  Carmit Rubin²  Gili Regev-Yochay³  Galia Rahav⁴  Adi Cohen⁵  Muhannad Daana⁵  Hector Roizin⁵  Meir Raz⁵  Samantha Hasleton⁵ 

[1] Immunisation Department, Health Protection, Public Health England, 61 Colindale Ave, NW9 5EQ, London, UK;Infectious Disease Epidemiology Section, The Gertner Institute, 52621, Tel Hashomer, Israel;Infectious Disease Epidemiology Section, The Gertner Institute, 52621, Tel Hashomer, Israel;Infectious Disease Unit, Chaim Sheba Medical Center, 52621, Ramat Gan, Israel;Infectious Disease Unit, Chaim Sheba Medical Center, 52621, Ramat Gan, Israel;Jerusalem-Hashfela District, Macabbi Healthcare Services, Modiin, Israel;

关键词: Influenza;    Primary Care Physician;    Influenza Vaccination;    Jewish Population;    Canadian Community Health Survey;   

DOI  :  10.1186/s12939-015-0193-8

 received in 2015-02-25, accepted in 2015-07-20,  发布年份 2015

来源: Springer

【 摘 要 】

IntroductionProvision of healthcare is considered a basic human right. Delivery and uptake is affected by many complex factors. Routine vaccinations are provided free of charge in Israel to all residents. The Palestinian Israeli Collaborative Research (PICR) group conducted research on vaccine impact at eight primary care facilities in east Jerusalem (EJ) and central Israel (IL) which allowed assessment and comparison of interactions of these Arab and Jewish populations, respectively, with healthcare services.MethodsFamilies attending clinic with a child under five years old were invited to participate. Utilisation of healthcare was assessed using data from standardise questionnaires completed after enrolment, using proxies of vaccination status, antibiotic use, primary care physician and hospital visits as well as demographics such as household size. Differences between EJ and IL were assessed using chi squared tests; univariate analyses identified potential confounders which were tested in a multiple logistic regression model for any independent associations between region and outcome.ResultsChildren in EJ were significantly more likely to live in larger households, with tobacco smokers, to have been breastfed, hospitalised and used antibiotics recently than those in IL, who were significantly more likely to have recently seen a primary care physician (all p < 0.01). Receipt of routine vaccinations, given at well baby clinics, was similar between the regions at above 95 % (p = 0.11), except for influenza which was delivered separately at primary physician clinics to 5 % (EJ) and 12 % (IL). Receipt of pneumococcal vaccine when paid for separately was significantly higher in IL than EJ (3 % vs 31 %). Multivariate analysis identified the most important independent predictors of these differences as region, age and household size.ConclusionsHealthcare in Israel is of a very high standard, but it is not uniformly utilised within the community in all geographical areas, though in some key areas, such as uptake of most routine childhood vaccination, equality seems to be achieved. To ensure excellent healthcare is achieved across the population, inequalities must be addressed, for instance in health promotion and other activities, which could improve and normalise health outcomes.

【 授权许可】

Unknown   
© Southern et al. 2015. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.