title: 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.
  
  
  OBJECTIVE
  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.
authors.affiliation: Department of Health Systems Management, Faculty of Health Sciences, Ben Gurion University in the Negev, Israel. nadavd@bgu.ac.il
authors.forename: Nadav
authors.initials: N
authors.lastname: Davidovitch
authors.forename: Dani
authors.initials: D
authors.lastname: Filc
authors.forename: Lena
authors.initials: L
authors.lastname: Novack
authors.forename: Ran D
authors.initials: RD
authors.lastname: Balicer
mesh_terms: D000328:Adult; D000368:Aged; D003469:Culture; D016208:Databases, Factual; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D054624:Health Status Disparities; D006760:Hospitalization / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D007348:Insurance, Health; D007557:Israel; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D019472:Universal Health Insurance