Summary: Inter-hospital transfers play a critical role in mass casualty events. On October 7, 2023, 3,000 Hamas terrorists invaded Israel from Gaza, killing 1,200 and injuring 1,455, triggering an ongoing military conflict. In routine times, Israel’s smallest hospital, Yoseftal Medical Center (YMC) in Eilat, transfers complex patients to the closest tertiary care hospital, Soroka Medical Center (SMC) in Beer-Sheva. However, this hospital was also closest to Gaza and began receiving injured soldiers. The war initially resulted in a disruption of inter-hospital transfer patterns, where patients routinely transferred from YMC to SMC, were sent to a hospital further away, Hadassah Medical Center Ein Kerem (HMC-EK), in Jerusalem. The objective of this study is to describe the downstream effects of armed conflict on inter-hospital transfers. Data on patients transferred from YMC to HMC-EK from January 1, 2022 - January 2, 2024, was collected retrospectively from the HMC centralized administrative database. During the study period, all 21 patients transferred from YMC to HMC-EK, arrived after October 7, 2023. The mean age was 61.8 years (± 14.4) and 76.2% were male. Most (n=10, 47.6%) arrived in October with decreasing percentages in November (n=9, 42.9%) and December (n=2, 9.5%). The majority of patients were treated by cardiology specialists (61.9%). During an ongoing military conflict or disaster, hospitals that receive secondary transfers of patients in need of more advanced care than locally available may be overwhelmed. Further studies of the downstream effects of MCEs and disasters on inter-hospital transfers and ED utilization should be conducted to help develop protocols to improve patient care during these events.
Alpert et al. (2026) studied this question.