Inequalities in healthcare utilization between refugees and non-refugees in Palestine

Inequalities in healthcare utilization between refugees and non-refugees in Palestine | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Inequalities in healthcare utilization between refugees and non-refugees in Palestine Waad Bani Odeh, Yousef Daoud, Sameera Awawda This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5579490/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Research on disparities in healthcare utilization between refugees and non-refugees in Palestine is limited. Socioeconomic challenges, health-related behaviors, and political obstacles are significant factors contributing to these disparities, impacting the well-being of vulnerable populations. This study explores the factors of healthcare utilization differences between Palestinian refugees and non-refugees in the West Bank and Gaza Strip. Methods We used the Fairlie decomposition approach, moderation analysis, and binary logistic regression to examine healthcare utilization variations using data from the 2021 Socio-Economic & Food Security Survey. These statistical techniques were used to evaluate how socioeconomic factors, health-related behaviors, and political obstacles affected the utilization of healthcare. Results The results indicate that compared to non-refugees, refugees depend more on aid. Even though non-refugees spend more on healthcare, logistic regression shows that, after controlling for economic and demographic variables, being a non-refugee associates negatively with healthcare utilization. The Fairlie decomposition analysis highlights that the Israeli occupation's restrictions play a significant role in healthcare utilization discrepancies . Conclusions In order to reduce healthcare disparities in Palestine, the study emphasizes the importance of particular policies. To reduce these discrepancies, more assistance for non-refugee populations should be accompanied by regular assistance for refugees from agencies such as UNRWA. Inequality in healthcare Healthcare utilization Refugees Non-refugees Political barriers Socioeconomic factors Palestine Full Text Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5579490","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":451128329,"identity":"e1c9b3b8-dae7-4e0a-8209-d9707215befa","order_by":0,"name":"Waad Bani Odeh","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA7klEQVRIiWNgGAWjYDACCSBOYGBmMGBvAJKkaeE5QIoWBpAWiQQitRjcbn724EGFtZy55NuDnwv+MNj1SySwPfyBT8udY+YGCWfSjS1n5yVLz2xjSJ45I4HdmAePFrMbCWYSiW2HEzfczjFj5m1gSDY4c4BNGp/DzG6kfwNpqd9w84wZM88fiBZJfA4zu5EDtiXB4AYPUAsbg53B8QY2CXwOs79zpkwC6BfDDWfAfpFIkGxvbMfrF8nZ7dskf1RYyxscPwsKMRt7fmbmY3hDDAmATZZIbGBgbCNOA1QLgz0QsxGrZRSMglEwCkYGAACVEExDoym1eAAAAABJRU5ErkJggg==","orcid":"","institution":"Palestinian Central Bureau of Statistics","correspondingAuthor":true,"prefix":"","firstName":"Waad","middleName":"Bani","lastName":"Odeh","suffix":""},{"id":451128330,"identity":"e34d27cd-5142-43f8-9c34-02264ae0e286","order_by":1,"name":"Yousef Daoud","email":"","orcid":"","institution":"College of Business and Economics Birzeit University","correspondingAuthor":false,"prefix":"","firstName":"Yousef","middleName":"","lastName":"Daoud","suffix":""},{"id":451128331,"identity":"ef196530-b2b3-4e89-b66f-ec095517e3f3","order_by":2,"name":"Sameera Awawda","email":"","orcid":"","institution":"College of Business and Economics Birzeit University","correspondingAuthor":false,"prefix":"","firstName":"Sameera","middleName":"","lastName":"Awawda","suffix":""}],"badges":[],"createdAt":"2024-12-04 11:54:17","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5579490/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5579490/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":81928851,"identity":"ac12d666-d480-4cce-a453-96074717ef77","added_by":"auto","created_at":"2025-05-05 04:45:54","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":385944,"visible":true,"origin":"","legend":"","description":"","filename":"RevisedpaperInequalitiesinHealthcareutilization.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5579490/v1_covered_c92f234c-6cf6-4aeb-bf77-28a18e594652.pdf"}],"financialInterests":"","formattedTitle":"Inequalities in healthcare utilization between refugees and non-refugees in Palestine","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Inequality in healthcare, Healthcare utilization, Refugees, Non-refugees, Political barriers, Socioeconomic factors, Palestine","lastPublishedDoi":"10.21203/rs.3.rs-5579490/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5579490/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eResearch on disparities in healthcare utilization between refugees and non-refugees in Palestine is limited. Socioeconomic challenges, health-related behaviors, and political obstacles are significant factors contributing to these disparities, impacting the well-being of vulnerable populations. This study explores the factors of healthcare utilization differences between Palestinian refugees and non-refugees in the West Bank and Gaza Strip.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe used the Fairlie decomposition approach, moderation analysis, and binary logistic regression to examine healthcare utilization variations using data from the 2021 Socio-Economic \u0026amp; Food Security Survey. These statistical techniques were used to evaluate how socioeconomic factors, health-related behaviors, and political obstacles affected the utilization of healthcare.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe results indicate that compared to non-refugees, refugees depend more on aid. Even though non-refugees spend more on healthcare, logistic regression shows that, after controlling for economic and demographic variables, being a non-refugee associates negatively with healthcare utilization. The Fairlie decomposition analysis highlights that the Israeli occupation's restrictions play a significant role in healthcare utilization discrepancies .\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn order to reduce healthcare disparities in Palestine, the study emphasizes the importance of particular policies. 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