The ecology of medical care in Israel
Researchers: Yoni yosef1, Alexander kiderman2, David Chinitz2, Amnon lahad2
- IDF
- The Hebrew University in Jerusalem
Background: More than 50 years have passed since White described that approximately 75% of the population felt ill during a given month, a third sought medical attention and only a few were hospitalized.
Objectives: This paper describes for the first time the ecology of medical care in Israel.
Method: A telephone survey among a representative sample of the general population (>15y) in Israel was conducted. Influence of Socio-demographic factors over morbidity and consumption was examined using the t-test for quantitative continuous variables and X² for qualitative variables. Logistic regression was used for multivariate analysis. In-depth interviews were also conducted among a small number of participants and were analyzed using the phenomenological qualitative research method.
Findings: 1,862 respondents participated. 49.5% reported suffering from any illness during the previous month, 45% considered asking for medical assistance, 35.2% got medical assistance and only 1.5% were hospitalized.
Respondents living in the periphery gave up medical assistance 42% more than others (P value 0.026). 58% chose to seek for a family physician assistance. 80% of the cases treated by a family physician were contained in a primary care setting, 17% were referred to a consultant physician, 2% were referred to the ER and 1% were hospitalized. Availability, accessibility and cost of visit were mentioned as important factors influencing consumption.
A good relationship with a family physician and appreciation for him have encouraged consumption.
Respondents living in the periphery gave up medical assistance 42% more than others (P value 0.026). 58% chose to seek for a family physician assistance. 80% of the cases treated by a family physician were contained in a primary care setting, 17% were referred to a consultant physician, 2% were referred to the ER and 1% were hospitalized. Availability, accessibility and cost of visit were mentioned as important factors influencing consumption.
A good relationship with a family physician and appreciation for him have encouraged consumption.
Discussion and recommendations: Subjective morbidity in Israel is significantly lower than in literature (50% and 75%, respectively) On the other hand, a larger percentage of the population in Israel is considering receiving medical assistance during a given month, and the actual consumption of medical services is higher (35% and 25%, respectively). Waiver of medical assistance was related only to one parameter, center versus periphery. Therefore, it seems that the existing health system enables the Israeli public to receive assistance when necessary, but in an unequal manner. Family medicine, as suggested by the study, may narrow this gap.
Research number: R/149/2013
Research end date: 01/2018