Pediatric undocumented immigrants require more hospitalizations and longer in-patient stay than the local  citizen population

Background: The ongoing global refugee crisis has raised concerns among medical communities worldwide. Methods: We compared data from undocumented immigrant children and Israeli citizen children (ICC) admitted to the pediatric department (PD) at Wolfson hospital in Israel, between 2013–2017. Results: 104,244 visits (0-18 years) to the pediatric emergency department (PED) were recorded. The admission rates to the PD for undocumented immigrant children was 695/2541 (27%) as compared to 11,858/101,703 (11.7%) for Israeli citizen children (P< 0.001). After matching for age groups (0-5 years), the hospital stay duration for the 0-2 years age was 3.22 (±4.80) days for undocumented immigrant children and 2.78 (±3.17) for the local Israeli citizen population (P<0.03). For 0-2 year old children, re-admission rates within 7 days were 1.3% for undocumented immigrant children and 2.6% for Israeli, (p<0.05). Dermatological diseases (mainly impetigo and cellulitis) were more frequent in undocumented immigrant children (23.30% vs. 13.15%, p<0.01), however, acute gastroenteritis and respiratory diagnoses were more common in Israeli citizen children (11.72% vs. 18.52%, p<0.05 and 6.26% vs. 14.84%, p<0.01, respectively). Neurological diseases (mainly febrile convulsions) were also more frequent in Israeli citizen children (7.7% vs. 3%, P<0.05). Very significantly, 23% of undocumented immigrant children had no health care coverage, while only 0.2% of the Israeli citizen children had no medical coverage (P < 0.001). Conclusion: We found evidence for significant morbidity in undocumented immigrant children as compared to the local Israeli citizen pediatric population, highlighting the need for health policy changes on a national level to provide some sort of health coverage for all children.