1
|
Premji S, Begum M, Medley A. Systemic barriers to reporting work injuries and illnesses in contexts of language barriers. Am J Ind Med 2023; 66:122-131. [PMID: 36537884 DOI: 10.1002/ajim.23453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 12/01/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Workers who experience language barriers are at increased risk of work-related injuries and illnesses and face difficulties reporting these health problems to their employer and workers' compensation. In the existing occupational health and safety literature, however, such challenges are often framed in individual-level terms. We identify systemic barriers to reporting among injured workers who experience language barriers within the varying contexts of Ontario and Quebec, Canada. METHODS This study merges data from two qualitative studies that investigated experiences with workers' compensation and return-to-work, respectively, for injured workers who experience language barriers. We conducted semi-structured interviews with 39 workers and 70 stakeholders in Ontario and Quebec. Audio recordings were transcribed and coded using NVivo software. The data was analysed thematically and iteratively. RESULTS Almost all workers (34/39) had filed a claim, though most had initially delayed reporting their injuries or illnesses to their employer or to workers' compensation. Workers faced several obstacles to reporting, including confusion surrounding the cause and severity of injuries and illnesses; lack of information, misinformation, and disinformation about workers' compensation; difficulties accessing and interacting with care providers; fear and insecurity linked to precarity; claim suppression by employers; negative perceptions of, and experiences with, workers' compensation; and lack of supports. Language barriers amplified each of these difficulties, resulting in significant negative impacts in economic, health, and claim areas. CONCLUSION Improving the linguistic and cultural competence of organizations and their representatives is insufficient to address under-reporting among workers who experience language barriers. Efforts to improve timely reporting must tackle the policies and practices that motivate and enable under-reporting for workers, physicians, and employers.
Collapse
Affiliation(s)
- Stephanie Premji
- School of Labour Studies, McMaster University, Hamilton, Ontario, Canada
| | | | - Alex Medley
- Faculty of Common Law, University of Ottawa, Ontario, Canada
| |
Collapse
|
2
|
Savitsky B, Radomislensky I, Goldman S, Kaim A, Bodas M. The surfacing portion of the Iceberg of the Domestic Violence Phenomenon-data from the Israeli National Trauma Registry. Isr J Health Policy Res 2021; 10:69. [PMID: 34857052 PMCID: PMC8637030 DOI: 10.1186/s13584-021-00499-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 11/05/2021] [Indexed: 11/10/2022] Open
Abstract
Background Domestic violence against women, which is an ancient phenomenon, is still thriving worldwide. The burden of domestic violence that is non-fatal on scene and its consequences in Israel are unknown. The purpose of this study was to provide evidence-based data regarding domestic violence-related hospitalizations among women in Israel. Methods The study is a retrospective cohort study of hospitalized patients included in the Israeli National Trauma Registry between January 1, 2011 and December 31, 2020. All women aged 14 and older, hospitalized due to a violence-related injury in one of the six-level I Trauma Centers or one of the 15 regional Trauma Centers in Israel were included (n = 676). Results Domestic violence contributes to moderate, severe, and critical injuries in a quarter of abused hospitalized women. Among these women, 20% underwent surgery, and in-hospital mortality was recorded for 2% of the patients. For most cases (53%), the spouse or ex-spouse caused the injury. The family relationship with the perpetrator was distributed differently between the population groups. The proportion of brothers who attacked sisters was greatest among Arabs (14.4%), while the phenomenon of attacking a mother was infrequent in the Arab sub-group. In contrast, among Jewish women, the proportion of those injured by a son was high, especially among the group of Jewish immigrants from the Former Soviet Union (FSU) (17%) and other countries (26%). In a multivariable logistic regression model with at least moderate injury as a dependent variable, in comparison to Israeli Arabs, Jews had a higher odds for sustaining at least moderate injuries, while the odds of Jewish immigrants not from FSU or Ethiopia were the highest (OR = 4.5, 95% CI 2.0–9.9). The annual hospitalization risk was 1.3/100,000 and 5.8/100,000, respectively for Jews and Arabs in 2020, almost fivefold higher among Arab women in comparison to Jewish women (RR = 4.6, 95% CI 2.9–7.3). Conclusions Domestic violence prevention should pay special attention to populations at risk, such as Arab women and new immigrants, as those women are especially vulnerable and often without sufficient family support and lack of economic resources to exit the trap of domestic violence. The collaboration between social and health services, the police, and the local authorities is crucial.
Collapse
Affiliation(s)
- Bella Savitsky
- Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Public Health Policy Research, Sheba Medical Center, 52621, Tel-Hashomer, Ramat Gan, Israel. .,School of Health Sciences, Ashkelon Academic College, Ashkelon, Israel.
| | - Irina Radomislensky
- Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Public Health Policy Research, Sheba Medical Center, 52621, Tel-Hashomer, Ramat Gan, Israel
| | - Sharon Goldman
- Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Public Health Policy Research, Sheba Medical Center, 52621, Tel-Hashomer, Ramat Gan, Israel
| | - Arielle Kaim
- Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Public Health Policy Research, Sheba Medical Center, 52621, Tel-Hashomer, Ramat Gan, Israel.,Department of Disaster Management, School of Public Health, Tel Aviv University, Tel Aviv, Israel
| | | | - Moran Bodas
- Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Public Health Policy Research, Sheba Medical Center, 52621, Tel-Hashomer, Ramat Gan, Israel.,Department of Disaster Management, School of Public Health, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
3
|
Wändell P, Li X, Carlsson AC, Sundquist J, Sundquist K. Osteoporotic fractures in second-generation immigrants and Swedish natives. Osteoporos Int 2021; 32:1343-1350. [PMID: 33469689 PMCID: PMC8192377 DOI: 10.1007/s00198-020-05776-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 12/03/2020] [Indexed: 12/11/2022]
Abstract
UNLABELLED In this national study of osteoporotic fractures in second-generation immigrants in Sweden, we found a similar risk of osteoporotic fractures in general compared to Swedish natives, which suggests that environmental factors are important for the high risk of osteoporotic fractures in Nordic countries. INTRODUCTION Second generation immigrants may have a similar environment as individuals with two native-born parents. These individuals may be of interest to study concerning whether environmental or hereditary factors could be mostly associated to the risk of osteoporotic fractures. The aim of this study was to analyse the risk of osteoporotic fractures in second-generation immigrants compared to Swedish natives. METHODS This was a nationwide study of individuals aged 50 years of age and older (N = 1,377,035; 691,750 men and 685,285 women). Osteoporotic fractures were defined as at least one registered diagnosis of fractures in the hip, humerus, forearm or vertebrae, in the National Patient Register between January 1, 1998, and December 31, 2012. Cox regression analysis was used to estimate the relative risk (hazard ratios (HR) with 95% confidence intervals (CI)) of incident osteoporotic fractures in second generation immigrants compared to Swedish natives. The Cox regression models were adjusted for age, comorbidities and for sociodemographic status. RESULTS A total of 114,505 osteoporotic fractures were registered, 109,622 (8.4%) were among individuals with Swedish-born parents and 4883 (7.5%) among those with foreign-born parents, with distal forearm fractures dominating in general (44.9%). Fully adjusted HRs (95% CI) were for all immigrants 0.95 (95% CI, 0.91-0.99), for men 0.96 (95% CI, 0.89-1.04) and for women 0.95 (95% CI, 0.90-1.00). CONCLUSIONS We observed a similar risk of osteoporotic fractures among second-generation immigrants as in Swedish natives, which suggests that environmental factors are important for osteoporotic fractures.
Collapse
Affiliation(s)
- P Wändell
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Allé 23, SE-141 83, Huddinge, Sweden.
| | - X Li
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - A C Carlsson
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Allé 23, SE-141 83, Huddinge, Sweden
- Academic Primary Health Care Centre, Stockholm Region, Stockholm, Sweden
| | - J Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Community-based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Matsue, Japan
| | - K Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Community-based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Matsue, Japan
| |
Collapse
|
4
|
Premji S, Begum M, Medley A, MacEachen E, Côté D, Saunders R. Le retour au travail dans un contexte de barrières linguistiques : Une étude comparative des politiques et des pratiques d’indemnisation des victimes de lésion professionnelle au Québec et en Ontario. PERSPECTIVES INTERDISCIPLINAIRES SUR LE TRAVAIL ET LA SANTÉ 2021. [DOI: 10.4000/pistes.7007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
5
|
Premji S, Begum M, Medley A, MacEachen E, Côté D, Saunders R. Return-to-Work in a Language Barrier Context : Comparing Quebec’s and Ontario’s Workers’ Compensation Policies and Practices. PERSPECTIVES INTERDISCIPLINAIRES SUR LE TRAVAIL ET LA SANTÉ 2021. [DOI: 10.4000/pistes.7144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
|
6
|
Savitsky B, Radomislensky I, Goldman S, Gitelson N, Frid Z, Peleg K. Socio-economic disparities and returning to work following an injury. Isr J Health Policy Res 2020; 9:35. [PMID: 32616064 PMCID: PMC7330957 DOI: 10.1186/s13584-020-00392-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 06/23/2020] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Traumatic injury is one of the main reasons for temporary and permanent occupational disability. The objective of this study was to define the role of socio-economic position on post-injury occupational absenteeism. METHODS This was a nationwide retrospective cohort study, based on linking The Israeli National Trauma Registry (INTR) and the National Insurance Institute (NII) databases. The study population included 44,740 injured workers (residents of Israel, aged 21-67, hospitalized between 2008 and 2013 and employed prior to injury as salaried workers). Logistic-regression models tested the probability of not returning to work (RTW). RESULTS The majority of the study population (61%) RTW within 1 month following the injury event. Income prior to injury was significantly associated with longer out of work stay, explaining 9% variance. A significant interaction (p value < 0.0001) was found between age and income on out of work stay more than 1 month, 1 year and 2 years. Logistic regression models of out of work stay were conducted separately for all age groups. Lower income was associated with greater chance for out of work stay for more than 1 month; and the gap between the lowest and highest income quartiles was greater among older workers (age 55+), where there was an elevenfold increase in probability of not RTW among casualties from the lowest vs. highest income quartile. In comparison to other population groups, Arabs were at greater odds of longer out of work stay following an injury. Among injured persons recognized by the NII as having occupational injuries, the odds for not RTW within a month, a year and 2 years were respectively 3.9, 2.5 and 2.2 times significantly greater in comparison to employees injured outside the workplace. CONCLUSIONS This study identified population groups with a high probability of not RTW following an injury requiring hospitalization. Intervention programs for injured employees should promote early rehabilitation and aim to shorten out of work stay. These programs should be ethnically adapted and focus on underprivileged and disadvantaged populations.
Collapse
Affiliation(s)
- Bella Savitsky
- Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Public Health Policy Research, Sheba Medical Center, Tel-Hashomer, 52621 Ramat Gan, Israel
| | - Irina Radomislensky
- Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Public Health Policy Research, Sheba Medical Center, Tel-Hashomer, 52621 Ramat Gan, Israel
| | - Sharon Goldman
- Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Public Health Policy Research, Sheba Medical Center, Tel-Hashomer, 52621 Ramat Gan, Israel
| | - Natalia Gitelson
- The National Insurance Institute of Israel, Research Center, Sderot Weizmann 13, Jerusalem, Israel
| | - Zhanna Frid
- The National Insurance Institute of Israel, Research Center, Sderot Weizmann 13, Jerusalem, Israel
| | - Kobi Peleg
- Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Public Health Policy Research, Sheba Medical Center, Tel-Hashomer, 52621 Ramat Gan, Israel
- Department of Disaster Management, School of Public Health, Tel Aviv University, Tel-Aviv, Israel
| |
Collapse
|
7
|
Marom BS, Sharabi M, Carel RS, Ratzon NZ. Returning to work after a hand injury: Does ethnicity matter? PLoS One 2020; 15:e0229982. [PMID: 32155201 PMCID: PMC7064188 DOI: 10.1371/journal.pone.0229982] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 02/19/2020] [Indexed: 11/19/2022] Open
Abstract
Background Hand injuries (HI) are common and may limit participation in work. The objective of this study is to examine the effect of ethnicity and other prognostic variables on return-to-work (RTW) among male manual workers after acute HI. Methods A cohort of 178 subjects (90 Arabs, 88 Jews) aged 22 to 65 was studied. Trained bilingual occupational therapists evaluated and interviewed the subjects, using structured validated questionnaires for evaluating personal and environmental factors, body function and structure, and activity limitation and participation restrictions. Employment status 3 months post injury was assessed by a telephone interview. To establish a predictive model for RTW, ethnicity and certain variables of the four domains mentioned above were analyzed using logistic regression analysis. Results A significant difference in the rate of RTW between Jews and Arabs was found (45.5% for Jews, 28.9% for Arabs, p = 0.03) three months post HI. In the univariate regression analysis, ethnicity was associated with RTW (OR = 2.05; CI: 1.10–3.81) for Jews vs. Arabs. Using a multivariate analysis, only legal counseling, educational attainment, and the severity of disability were significantly associated with RTW. Conclusion RTW three months post HI among manual workers is directly related to variables such as education and legal counseling and only indirectly related to ethnicity. Patients with a lower level of education and those who were engaged in legal counseling need special attention and close guidance in the process of RTW.
Collapse
Affiliation(s)
- Batia S. Marom
- Occupational Therapy Unit, Clalit Health Services, Tiberias, Israel
- * E-mail:
| | - Moshe Sharabi
- Sociology and Anthropology Department, Max Stern Yezreel Valley College, Yezreel Valley, Israel
| | - Rafael S. Carel
- School of Public Health, The University of Haifa, Haifa, Israel
| | - Navah Z. Ratzon
- Department of Occupational Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
8
|
Kang JY, Kwon J, Sohn CH, Kim YJ, Lim HW, Lee SJ, Kim WY, Kim N, Seo DW. Big Data-Driven Approach for Health Inequalities in Foreign Patients with Injuries Visiting Emergency Rooms. Healthc Inform Res 2020; 26:34-41. [PMID: 32082698 PMCID: PMC7010947 DOI: 10.4258/hir.2020.26.1.34] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 11/04/2019] [Accepted: 01/17/2020] [Indexed: 12/02/2022] Open
Abstract
Objectives Foreign patients are more likely to receive inappropriate health service in the emergency room. This study aimed to investigate whether there is health inequality between foreigners and natives who visited emergency rooms with injuries and to examine its causes. Methods We analyzed clinical data from the National Emergency Department Information System database associated with patients of all age groups visiting the emergency room from 2013 to 2015. We analyzed data regarding mortality, intensive care unit admission, emergency operation, severity, area, and transfer ratio. Results A total of 4,464,603 cases of injured patients were included, of whom 67,683 were foreign. Injury cases per 100,000 population per year were 2,960.5 for native patients and 1,659.8 for foreign patients. Foreigners were more likely to have no insurance (3.1% vs. 32.0%, p < 0.001). Serious outcomes (intensive care unit admission, emergency operation, or death) were more frequent among foreigners. In rural areas, the difference between serious outcomes for foreigners compared to natives was greater (3.7% for natives vs. 5.0% for foreigners, p < 0.001). The adjusted odds ratio for serious outcomes for foreign nationals was 1.412 (95% confidence interval [CI], 1.336–1.492), and that for lack of insurance was 1.354 (95% CI, 1.314–1.394). Conclusions Injured foreigners might more frequently suffer serious outcomes, and health inequality was greater in rural areas than in urban areas. Foreign nationality itself and lack of insurance could adversely affect medical outcomes.
Collapse
Affiliation(s)
- Jin Young Kang
- Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jinhee Kwon
- Department of Biomedical Engineering, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chang Hwan Sohn
- Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Youn-Jung Kim
- Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyo Won Lim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | | | - Won Young Kim
- Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Namkug Kim
- Department of Convergence Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dong-Woo Seo
- Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.,UCSD Health Department of Biomedical Informatics, University of California San Diego, La Jolla, CA, USA
| |
Collapse
|
9
|
Tiruneh A, Siman-Tov M, Givon A, Trauma Group I, Peleg K. Comparison between traumatic brain injury with and without concomitant injuries: an analysis based on a national trauma registry 2008-2016. Brain Inj 2019; 34:213-223. [PMID: 31661634 DOI: 10.1080/02699052.2019.1683893] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: To compare demographic, injury and hospitalization characteristics and mortality between Isolated and Non-Isolated traumatic brain injury.Methods: A retrospective study based on the Israeli National Trauma Registry of patients hospitalized for traumatic brain injury (TBI) between 2008 and 2016. Isolated TBI was defined as no other anatomic region was having concomitant injury with AIS ≥2. X2 test and multivariate logistic regression analysis were used for data analysis.Results: Of the 23566-study population, 40.4% were admitted for isolated TBI. Isolated TBI was significantly more frequent in elderly aged ≥65 years, female, Jews, and injuries sustained at home or in residential institution. The Non-isolated TBI was greater in road traffic injuries, particularly among pedestrians and motor cyclists, and in violence injuries. The Non-isolated TBI group had greater injury severity and hospital resource utilization. In-hospital mortality was higher in the patients with Non-isolated TBI [OR: 1.56(95% CI: 1.33-1.83)], particularly in patients with GCS 13-15; elderly aged 65+ years; and patients with concomitant injuries to abdomen, spine or external body regions.Conclusion: In a patient with TBI, concomitant injuries with AIS ≥2 matter, and awareness of the identified factors has relevance for guiding injury prevention efforts and indeed for potentially improving care and outcome.
Collapse
Affiliation(s)
- Abebe Tiruneh
- Israel National Center for Trauma and Emergency Medicine, Gertner Institute for Epidemiology and Health Policy Research, Ramat Gan, Israel
| | - Maya Siman-Tov
- Israel National Center for Trauma and Emergency Medicine, Gertner Institute for Epidemiology and Health Policy Research, Ramat Gan, Israel
| | - Adi Givon
- Israel National Center for Trauma and Emergency Medicine, Gertner Institute for Epidemiology and Health Policy Research, Ramat Gan, Israel
| | - Israel Trauma Group
- Israel National Center for Trauma and Emergency Medicine, Gertner Institute for Epidemiology and Health Policy Research, Ramat Gan, Israel, Israel Trauma Group includes: H. Bahouth, A. Becker, A. Hadary, I. Jeroukhimov, M. Karawani, B. Kessel, Y. Klein, G. Lin, O. Merin, B. Miklush, Y. Mnouskin, A. Rivkind, G. Shaked, G. Sibak, D. Soffer, M. Stein, M. Wais, H. Pharan and I. Garbetzev
| | - Kobi Peleg
- Israel National Center for Trauma and Emergency Medicine, Gertner Institute for Epidemiology and Health Policy Research, Ramat Gan, Israel.,Department of Disaster Management, School of Public Health, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
10
|
Tiruneh A, Radomislensky I, Peleg K, Siman-Tov M. Minorities and foreign born are disproportionately affected by injuries due to violence: an analysis based on a National Trauma Registry 2008-2017. Isr J Health Policy Res 2019; 8:29. [PMID: 30845989 PMCID: PMC6407275 DOI: 10.1186/s13584-019-0297-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Accepted: 02/25/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Populations of different ethnicity and country of origin living in the same country may possess particular features of violence-related injuries. This study aims to compare violence-related injury characteristics and circumstances, hospital resource utilization and in-hospital mortality among the major ethnic groups in Israel. METHODS A study based on the Israeli National Trauma Registry database of patients hospitalized due to violence-related injuries between 2008 and 2017. Data included demographic, injury and hospitalization characteristics and in-hospital mortality. Statistical analysis included χ2-test and multiple logistic regression. RESULTS During the study period, 16,151 violence related-hospitalizations were reported, of which; 46.1% were Arab Israelis (AI), 3.2% were Israelis born in Ethiopia (IBE), 12.7% were Israelis born in the former Soviet Union (IBFSU) and 38.0% were all other Israelis (AOI). The proportion of violence-related hospitalizations among AI, IBE and IBFSU was greater than their respective proportion in the Israeli population. In comparison to the other groups, stab injuries were significantly greater among IBE (30% vs 39%); unarmed brawl-related injuries were greater among IBFSU (22-41% vs 49%) and firearm injuries were greatest among AI (2-8% vs 23%). These differences in violence mechanism persisted even after accounting for age, gender, injury place and time differences. The foreign born groups had higher rates for injuries sustained on the street/road (58% for IBE, 54% for IBFSU vs 46% for AI and AOI, each), with IBE also showing higher rates for weekend and weeknight injuries compared to the other groups (83% vs 71-75%). IBE were more likely to suffer from severe and critical injuries (19% vs 12-16%), to be admitted to the intensive care unit (17% vs 9-11%) and to have prolonged hospital stays of seven days or more (20% vs 16-17%), with no significant difference in in-hospital mortality between the comparison groups. CONCLUSIONS Characteristics of violence-related casualties differed significantly among diverse ethnic populations living in the same country. Each population group showed specific attributes regarding injury mechanism, circumstances, severity and hospital utilization. Violence prevention programs should be culturally adapted and take into account ethnicity and country of origin of the target population.
Collapse
Affiliation(s)
- Abebe Tiruneh
- Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel-Hashomer, 52621, Ramat Gan, Israel
| | - Irina Radomislensky
- Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel-Hashomer, 52621, Ramat Gan, Israel
| | | | - Kobi Peleg
- Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel-Hashomer, 52621, Ramat Gan, Israel.,Department of Disaster Management, School of Public Health, Tel Aviv University, Tel Aviv, Israel
| | - Maya Siman-Tov
- Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel-Hashomer, 52621, Ramat Gan, Israel.
| |
Collapse
|
11
|
Klukowska-Röetzler J, Eracleous M, Müller M, Srivastava DS, Krummrey G, Keidar O, Exadaktylos AK. Increased Urgent Care Center Visits by Southeast European Migrants: A Retrospective, Controlled Trial from Switzerland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15091857. [PMID: 30154317 PMCID: PMC6164677 DOI: 10.3390/ijerph15091857] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 08/25/2018] [Accepted: 08/26/2018] [Indexed: 01/10/2023]
Abstract
We investigated whether immigrants from Southeast Europe (SE) and Swiss patients have different reasons for visiting the emergency department (ED). Our retrospective data analysis for the years 2013–2017 describes the pattern of ED consultations for immigrants from SE living in Switzerland (Canton Bern), in comparison with Swiss nationals, with a focus on type of referral and reason for admission. A total of 153,320 Swiss citizens and 12,852 immigrants from SE were included in the study. The mean age was 51.30 (SD = 21.13) years for the Swiss patients and 39.70 (SD = 15.87) years for the SE patients. For some countries of origin (Albania, Bosnia and Herzegovina, and Turkey), there were highly statistically significant differences in sex distribution, with a predominance of males. SE immigrants had a greater proportion of patients in the lower triage level (level 3: SE: 67.3% vs. Swiss: 56.0%) and a greater proportion of patients in the high triage level than the Swiss population (level 1: SE: 3.4% vs. Swiss: 8.8%). SE patients of working age (16–65 years) were six times more often admitted by ambulance than older (≥65 years) SE patients, whereas this ratio was similar in the Swiss population. In both groups, the fast track service was primarily used for patients of working age (<65) and more than three times more often in the SE than the Swiss group (SE: 39.1%, Swiss: 12.6%). We identified some indications for access to primary care in emergency departments for immigrants and highlighted the need for attention to the role of organizational characteristics of primary health care in Switzerland. We highlighted the need for professional support to improve the quality of healthcare for immigrants. In the future, we will need more primary care services and general practitioners with a migrant background.
Collapse
Affiliation(s)
| | - Maria Eracleous
- Department of Rheumatology, Immunology and Allergology, University Hospital, 3010 Bern, Switzerland.
| | - Martin Müller
- Department of Emergency Medicine, University Hospital, 3010 Berne, Switzerland.
- Institute of Health Economics and Clinical Epidemiology, University Hospital, 50935 Cologne, Germany.
| | - David S Srivastava
- Department of Emergency Medicine, University Hospital, 3010 Berne, Switzerland.
| | - Gert Krummrey
- Department of Emergency Medicine, University Hospital, 3010 Berne, Switzerland.
| | - Osnat Keidar
- Department of Emergency Medicine, University Hospital, 3010 Berne, Switzerland.
| | | |
Collapse
|