title: The emergency department in a region under missile attack: utilization patterns during Operation Cast Lead.
abstract: BACKGROUND
  During military escalations emergency departments provide treatment both to victims of conflict-related injuries and to routine admissions. This requires special deployment by the hospitals to optimize utilization of resources.
  
  
  OBJECTIVE
  To evaluate routine visits to the ED during Operation Cast Lead in Israel in 2008-2009.
  
  
  METHODS
  We obtained data regarding routine visits to the ED at Soroka University Medical Center throughout OCL. The visits one month before and after OCL and the corresponding periods one year previous served as controls.
  
  
  RESULTS
  The mean number of daily visits throughout the study period (126 days) was 506 +/- 80.9, which was significantly lower during OCL (443.5 +/- 82) compared with the reference periods (P < 0.001). Compared to the reference periods, during OCL the rates were higher among Bedouins, visitors from the region closest to the Gaza Strip (< 30 km), patients transported to the ED by ambulance and patients of employment age; the rates were lower among children. No difference in the different periods was found in the rate of women patients, the rate of patients referred to the ED by a community physician, and hour of arrival. The overall in-hospital admission rate increased during OCL, mainly in the internal medicine and the obstetric departments. There was no change in the number of in-hospital births during OCL; however, the rate of preterm labors (32-36 weeks) decreased by 41% (P = 0.013).
  
  
  CONCLUSIONS
  Throughout OCLthe number of routine ED visits decreased significantly compared to the control periods. This finding could help to optimize the utilization of hospital resources during similar periods.
authors: Clinical Research Center, Soroka University Medical Center, Beer Sheva, Israel. igalpl@clalit.org.il
authors: Ygal
authors: Y
authors: Plakht
authors: Arthur
authors: A
authors: Shiyovich
authors: Lauthman
authors: L
authors: Francine
authors: Yehuda
authors: Y
authors: Shoshan
authors: Dina
authors: D
authors: Antonovitch
authors: Nurit
authors: N
authors: Waknine
authors: Tal
authors: T
authors: Barabi
authors: Michael
authors: M
authors: Sherf
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000458:organization & administration / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D008887:Military Medicine; D007752:Obstetric Labor, Premature / Q000453:epidemiology; D011247:Pregnancy; D012189:Retrospective Studies; D013315:Stress, Psychological / Q000453:epidemiology; D014857:Warfare; D055815:Young Adult