@article{ref1,
title="Impact of repeated military conflicts on civilian patterns of emergency medical services utilization: a retrospective cohort study",
journal="American journal of disaster medicine",
year="2022",
author="Sonkin, Roman and Jaffe, Eli and Alpert, Evan Avraham and Zerath, Erik",
volume="17",
number="2",
pages="143-152",
abstract="OBJECTIVE: To assess the impact of repeated rocket attacks on a civilian population during successive military conflicts on the patterns of emergency medical services (EMS) utilization. <br><br>DESIGN: This retrospective cohort study (2008-2021) analyzed EMS data from one region of Israel characterized by intensive rocket attacks on a civilian population during four successive military conflicts. EMS activity for the periods prior to, during, and after the conflicts was compared. Data included call volume, type of calls (&quot;medical illness,&quot; &quot;motor vehicle collision (MVC),&quot; and &quot;other-injuries&quot;), and level of response (advanced life support (ALS) or basic life support (BLS)). <br><br>RESULTS: Compared to the Pre-Conflict period, there were statistically significant decreased volumes of calls during the 2008 (-20 percent), 2012 (-13 percent), and 2021 (-11 percent) military conflicts for &quot;medical illness&quot; and during the 2008 (-23 percent), 2012 (-30 percent), and 2021 (-31 percent) for &quot;MVC.&quot; Decreases in calls for &quot;medical illness&quot; were accompanied by decreased ALS dispatches (-28, -33, and -18 percent for 2008, 2012, and 2021, respectively). The number of calls returned to preconflict values during the Post-Conflict periods. No change was evidenced in numbers of calls during the 2014 military conflict. <br><br>CONCLUSION: Military conflicts involving a civilian population were usually found to be associated with lower numbers of calls for the categories of &quot;medical illness&quot; and &quot;MVC.&quot; Less calls for &quot;medical illness&quot; were associated with fewer ALS dispatches. There was a rapid return of call volumes to preconflict levels shortly after a ceasefire was reached. The absence of change in calls during the 2014 conflict suggests involvement of habituation processes.<p /> <p>Language: en</p>",
language="en",
issn="1932-149X",
doi="10.5055/ajdm.2022.0428",
url="http://dx.doi.org/10.5055/ajdm.2022.0428"
}