Inequalities in Use of Health Services among Jews and Arabs in Israel

OBJECTIVES: To compare the levels of utilization of health services in Jews and Arabs taking into account differences in levels of socioeconomic status (SES) in a country with a National Health Insurance Law (NHIL). DATA SOURCE/STUDY SETTING: A cross-sectional National Health Interview Survey was carried out in Israel based on a random sample of telephone numbers as part of the EUROHIS project (WHO European Health Interview Survey 2003-2004). STUDY DESIGN: A random telephone survey included 9,352 interviews. Questions included use of health care services, health status, and socioeconomic variables. PRINCIPAL FINDINGS: After adjusting for sex, age, income, education, marital status, and self-reported chronic diseases, Arabs more often reported visiting a family physician (odds ratio OR=1.56, 95 percent confidence interval CI=1.35-1.81) and less often reported visiting a specialist (OR=0.73, 95 percent CI=0.60-0.89) compared with Jews. In addition, the odds ratio for hospitalization was similar among Arabs and Jews (OR=1.16, 95 percent CI=0.97-1.38). SES was associated with utilization of health care services only in the Jewish population. CONCLUSIONS: A different pattern of utilization of health care services was observed in Arabs and Jews. This was not explained by differences in socioeconomic levels. More research is needed regarding the distribution of services between Jews and Arabs.