Researchers: Gitit Kavé¹, Ayala Bloch²

Background: Neuropsychological assessment (NPA) is a valuable tool that provides unique information about diagnosis and prognosis of individuals with various disorders, such as traumatic brain injury, degenerative disease, or stroke. The Israeli National Health Insurance Law covers NPA, yet awareness of NPA is low.

Objectives: We aimed to identify barriers to NPA referral within the Israeli healthcare system by investigating physicians’ and neuropsychologists’ knowledge of NPA referral procedures; by recording true referral rates; and by exploring referral policies.

Method: Collection of data from 274 physicians and 279 neuropsychologists, from Health Plans (HP) and The National Institute for the Rehabilitation of the Brain Injured, and from interviews with decision makers.

Findings: Most physicians had heard of NPA before, but did not know how to refer patients to NPA. Most practicing neuropsychologists conducted NPA, yet they conducted few NPAs through the HP and were unfamiliar with referral procedures. In 2018, Maccabi and Clalit funded 412 NPAs. Two NPAs at the National Institute for the Rehabilitation of the Brain Injured received HP funding over a 10-year period. Interviews with decision makers demonstrated that referral eligibility and procedures were open to interpretation, and they depended too heavily on the personal characteristics of the individual in charge of approving NPA rather than on patient needs.

Conclusions: Physicians and neuropsychologists are not familiar enough with referral procedures through the HP. For the HPs to provide good neuropsychological services, they must clarify referral procedures to relevant professionals.

Recommendations: HPs should clarify their referral procedures and distribute them to all relevant physicians and psychologists; the HPs should offer internship programs in rehabilitation psychology; neuropsychologists should work more closely with physicians within the public healthcare system; the training of physicians in relevant fields should introduce them to neuropsychology in general and to NPA in particular.

Research end date: 07/2020