Emergency Department Waiting Times in an Israeli Children's Hospital During Times of Military Conflict

Introduction: During military conflicts in southern Israel, many families moved north, and hospitals and primary care clinics under threat of missile attacks referred their patients to hospitals outside the combat zone, causing overcrowding of the emergency departments (ED). The study objective is to examine the effect of military conflicts on ED waiting time in a children's hospital outside the combat zone. Materials and Methods: A retrospective cohort study of patients admitted between January 2011 and December 2015 was conducted. Multivariable regression was used to examine the effect of age, gender, triage category, arrival time, weekday, and period of admission (peacetime and time of military conflict) on waiting time. Results: Totally, 79,825 children were admitted in peacetimes and 3,058 in times of military conflict. Factors that most influenced shorter waiting times were triage category 1 (change in waiting time: -25.5%; 95% confidence interval: -29.3 to -21.7) or triage category 2 (change in wait time: -21.8%; 95% confidence interval: -23.7 to -20.05). Arriving during times of military conflict did not influence ED waiting time (p=0.18). ED waiting times during times of peace and times of military conflict were 38 min of interquartile range (21-65) and 38 min of interquartile range (22-65), respectively. Conclusions: In this report of a large cohort of patients, waiting times were similar during periods of peace and periods of military conflict. The findings suggest that the 2012 and the 2014 military conflicts did not influence ED waiting times in a hospital outside the combat zone, despite the population shift that occurred during these conflicts. This study is the first to examine the association between periods of military conflict and ED waiting time in children.