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December 2017 (Volume 95)
December 2017 | Eytan Ellenberg, Mark I. Taragin, Jay R. Hoffman, Osnat Cohen, Daniella Luft-Afik, Zvia Bar-On, Ishay Ostfeld | Original Investigation
Context: Across the globe, the threat from terrorist attacks is rising, which requires a careful assessment of long-term medical support. Based on an 18-month follow-up of the Israeli civilian population following the 2014 war in Gaza, we describe and analyze the medical costs associated with rocket attacks and review the demography of the victims who filed claims for disability compensation.We then propose practical lessons to help health care authorities prepare for future confrontations.
Methods: Using the National Insurance Institute of Israel’s (NII) database, we conducted descriptive and comparative analyses using statistical tests (Fisher’s Exact Test, chi-square test, and students’ t-tests). The costs were updated until March 30, 2016, and are presented in US dollars. We included only civilian expenses in our analysis.
Findings: We identified 5,189 victims, 3,236 of whom presented with acute stress reactions during the conflict. Eighteen months after the conflict, the victims’ total medical costs reached $4.4 million. The NII reimbursed $2,541,053 for associated medical costs and $1,921,792 for associated mental health costs. A total of 709 victims filed claims with the NII for further support, including rehabilitation, medical devices, and disability pensions.
Conclusion: We found 3 major sources of costs: hospital expenditures, mental health services dedicated to acute stress reactions, and ambulatory follow-up. During the first year, most of the costs were related to hospitalization and support for stress relief. During the second year, ambulatory and rehabilitation costs continued to grow. Public health specialists should consider these major components of costs and their evolution over time to properly advise the medical and social authorities on allocating resources for the medical and nonmedical support of civilian casualties resulting from war or terror.
Keywords: terrorism, war, disaster, post–health services.
Read on Wiley Online Library
Volume 95, Issue 4 (pages 783-800)
Published in 2017
The Politics of Medicaid: Most Americans Are Connected to the Program, Support Its Expansion, and Do Not View It as Stigmatizing
On Effective Graphic Communication of Health Inequality: Considerations for Health Policy Researchers