Health services utilization under Qassam rocket attacks.
BACKGROUND
The Qassam rocket attacks on southern Israel during the years 2000-2007 created a unique situation of life undera continuous threat. The effect of this unique situation on health services utilization has not been previously examined.


OBJECTIVE
To evaluate health utilization patterns in two primary care clinics in southern Israel: one under continuous attacks of Qassam rockets as compared with a similar clinic not under a rocket threat.


METHODS
We conducted a retrospective cross-sectional study in two primary care clinics in southern Israel, with 11,630 persons listed in the two clinics during the entire study period. The primary outcome measures were total annual number of visits per person to the clinic and for specific diagnoses, and the number of drug prescriptions issued, emergency room (ER) visits, hospitalization days, cardiac catheterizations and coronary bypass surgeries.


RESULTS
In both clinics there was an increase over time in the mean annual number of visits per person. During the years of severe attacks there was an increase in visits with a chief complaint of depression and anxiety and an increase in the number of anxiolytic prescriptions in the study clinic compared with the control. During the same period there was a decrease in the number of ER visits in the study clinic compared with the control.


CONCLUSIONS
The population under continuous life-threatening events showed more depression and anxiety problems. Under severe bombardment, the residents prefer not to leave home, unless necessary.
Siaal Research Center, Division of Community Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel. litalmargalith@gmail.com
Lital
L
Goldberg
Jacob
J
Dreiher
Michael
M
Friger
Alexander
A
Levin
Pesach
P
Shvartzman
D000328:Adult; D000368:Aged; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D001007:Anxiety / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D023481:Terrorism / Q000523:psychology*; D055815:Young Adult
D014151:Anti-Anxiety Agents