Internally displaced persons' ed utilization and disease patterns: A single center retrospective chart review

Armed conflicts profoundly disrupt healthcare systems, with internally displaced persons (IDPs) facing distinct challenges and barriers to accessing healthcare. This study explores emergency department (ED) utilization patterns, disease spectrum, and patient outcomes of IDPs during conflict in comparison with non-IDPs (NIDPs).

A retrospective chart review was conducted on all patients presenting to the American University of Beirut Medical Center between October 7, 2024, and November 27, 2024. Patients were categorized into the IDPs and NIDPs groups based on documented residential status at the time of presentation. Specifically, we compared the demographic data, ED visit characteristics, and disease spectrums in displaced versus non-displaced patients in a tertiary care hospital in Lebanon.

A total of 5686 patients were reviewed, of which 776 and 4910 patients were identified as IDPs and NIDPS, respectively. Displaced patients tended to be younger (p < 0.001), insured (p < 0.001), and were more likely to arrive by ambulance (p < 0.001). A greater proportion of IDPs left without being seen, against medical advice, or were transferred to another hospital. Moreover, a higher proportion of IDPs who were admitted required critical care (CC) admission. Displacement, age, and guarantor type (3rd party coverage) emerged as distinct variables associated with the need for CC admission (p < 0.001, p = 0.02, p < 0.001, respectively).

ED utilization patterns of IDPs have distinct features that reflect the challenges they face regarding healthcare access as well as the higher complexity of cases, increased CC needs, and distinct disease spectrums for ED visits. These results highlight the importance of tailored health interventions for IDPs during times of conflict that address these challenges.