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Israel Journal of Health Policy Research

Yishay Wasserstrum, Racheli Magnezi, Ofer Tamir, Stav Koren, Dor Lotan, Arnon Afek
OBJECTIVES: To evaluate the effect of monetary grants on young physicians' choice of remote or rural hospital-based practice. BACKGROUND: In late 2011, The Israeli Ministry of Health attempted to address a severe physician maldistribution, which involved severe shortages in remotely-located institutions (RLI). The policy intervention included offering monetary grants to residents who chose a residency program in a RLI. METHODS: A total of 222 residents from various disciplines were recruited; 114 residents from RLI and 108 residents from central-located institutions (CLI), who began their residency during 2012-2014...
February 15, 2019: Israel Journal of Health Policy Research
Rina Maoz-Breuer, Oren Berkowitz, Rachel Nissanholtz-Gannot
BACKGROUND: A new role of Physician Assistant (PA) was introduced into Emergency Departments (ED) in Israel in 2016, as part of a larger effort to improve the quality of service in the EDs. When the new role was introduced, there was a fair amount of uncertainty about whether it would succeed, in light of ambivalence on the part of many ED nurses, and lack of clarity among ED directors about the necessity of a PA role, and about the extent to which PAs would be allowed to take on professionally meaningful tasks...
February 15, 2019: Israel Journal of Health Policy Research
Nura Abdel-Rahman, Nechemia Yoffe, Maya Siman-Tov, Irina Radomislensky, Kobi Peleg
OBJECTIVE: To determine if ethnic disparities exist with regard to the risk of injury and injury outcomes among elderly hospitalized casualties in Israel. METHODS: A retrospective study based on data from the Israeli National Trauma Registry between 2008 and 2017. Data included demographic, injury and hospitalization characteristics. Descriptive statistics and adjusted logistic regression were used to examine the differences between Jewish and Arab casualties, aged 65 and older...
February 13, 2019: Israel Journal of Health Policy Research
Deena R Zimmerman, Gina Verbov, Naomi Edelstein, Chen Stein-Zamir
PURPOSE: Pediatric preventive health services are delivered in many different formats throughout the world. In Israel, these services for young children are provided in designated Maternal Child Health Clinics (MCHC). The history and operation of Israel's MCHC have been described primarily in the Hebrew language medical literature with most of these reports being over a decade old. This paper provides an up to date summary of the evolution and current care in Israel's one-hundred-year old model for the provision of preschool preventive health services...
February 7, 2019: Israel Journal of Health Policy Research
Adi Kuperman-Shani, Tarif Bader, Elon Glassberg, Vered Klaitman
Israel has compulsory military service, beginning at the age of 18. Women serve about two years and men for about three years. However, de facto only some of the potential service entrants are recruited. Among women, those who enlist are mainly secular Jews who are unmarried; among men, most of the ultra-Orthodox Jews do not enlist. In addition, only a fraction of the recruits chooses to turn the military service into a career and sign up for additional service as professional military personal (officers and non-commissioned officers)...
February 4, 2019: Israel Journal of Health Policy Research
Rachel Yaffa Zisk-Rony, Charles Weissman, Yoram G Weiss
BACKGROUND: Mechanical ventilation is a life supporting modality increasingly utilized when caring for severely ill patients. Its increasing use has extended the survival of the critically ill leading to increasing healthcare expenditures. We examined changes in the hospital-wide use of mechanical ventilation over 20 years (1997-2016) in two Israeli hospitals to determine whether there were specific patterns (e.g. seasonality, weekday vs. weekend) and trends (e.g. increases or decreases) among various hospital departments and units...
February 1, 2019: Israel Journal of Health Policy Research
Amichai Perlman, Ehud Horwitz, Bruria Hirsh-Raccah, Gefen Aldouby-Bier, Tamar Fisher Negev, Sarit Hochberg-Klein, Yosef Kalish, Mordechai Muszkat
INTRODUCTION: In the past decade, direct-acting oral anticoagulants (DOAC) have been introduced to medical practice for several indications, with a wide range of dosing regimens. As both over- and under-dosing might lead to life-threatening events, development of methods promoting safe and effective utilization of these agents is imperative. The Hadassah Clinical Pharmacy team initiated a hospital-wide program, for monitoring and promoting safe and effective prescription of DOAC during hospitalization...
February 1, 2019: Israel Journal of Health Policy Research
Chanoch Miodownik, Michael D Friger, Eyal Orev, Yisroel Gansburg, Nadav Reis, Vladimir Lerner
BACKGROUND: Restraint or seclusion measures in acute psychiatric care are used as a last resort when all other methods for removal of physical threat have failed. The purpose of this study is to find a correlation between coercive measures, demographic characteristics within this patient group, and factors associated with shortened periods of restriction. METHODS: This is a one-year retrospective study conducted in a male acute closed ward of a psychiatric hospital in Israel...
February 1, 2019: Israel Journal of Health Policy Research
H Cody Meissner
An analysis of benefit and cost is critical for independent advisory groups that provide evidence-based recommendations. In many countries, the role of RSV immunoprophylaxis for infants at increased risk of hospitalization is controversial because of limited benefit and high cost. The report by Ginsberg and co-workers provides evidence, that in Israel, despite the potential benefit of palivizumab prophylaxis in reducing a small number of RSV hospitalizations but no evidence of long-term benefit, the cost is difficult to justify...
January 28, 2019: Israel Journal of Health Policy Research
Raida Daeem, Ivonne Mansbach-Kleinfeld, Ilana Farbstein, Robert Goodman, Rasha Elias, Anneke Ifrah, Gabriel Chodick, Rassem Khamaisi, Silvana Fennig, Alan Apter
BACKGROUND: The Galilee Study is the first large epidemiological study to compare correlates of mental disorders between two Arab Palestinian minority groups of adolescents in Israel. METHODS: A two-stage cross-sectional study, carried out between 2012 and 2014, included all 9th grade students from 5 Arab localities, representative of 77% of the Muslim and 100% of Druze citizens in Israel. During the screening stage, 1639 students completed the Strengths and Difficulties Questionnaire in the classroom (response rate = 69...
January 21, 2019: Israel Journal of Health Policy Research
Dana Barequet, Aviad Tur-Sinai, Irit Barequet
The Israel Ministry of Health enacted regulations that aim to reduce private expenditure on healthcare services and mitigate social inequality. According to the modified rules, which went into effect in the second half of 2016, patients who undergo surgery in a private hospital and are covered by their healthcare provider's supplemental insurance (SI) make only a basic co-payment.The modified regulations limited the option of self-payment for advanced devices not covered by national health basket, meaning that patients for whom such devices are indicated had to pay privately for the entire procedure...
January 17, 2019: Israel Journal of Health Policy Research
Jochanan Benbassat
Observational studies have detected discrepancies between two expert interpreters of imaging and histopathological studies. Furthermore, in a substantial proportion of patients, an independent second opinion disagreed with the first one. Therefore, it is widely accepted that patients have a right to obtain a second opinion and, in case of divergent opinions, to deliberate and choose the option that they believe is most consistent with their individual circumstances. However, doctors are less likely to inform old and poorly educated patients about the possibility of seeking a second opinion, and this may contribute to healthcare inequalities...
January 16, 2019: Israel Journal of Health Policy Research
Laura J Rosen, David A Rier, Robert Schwartz, Michal Talitman, Lior Zwanziger
BACKGROUND: Devastation from the tobacco epidemic continues, with strong government tobacco control policy absent in most countries. Knowledge of the full scope of tobacco harm in populations may form the basis for healthier behavior, de-normalization of smoking, and a consensus about necessary public policy. However, many populations may be poorly-informed about the risks, and this ignorance may undermine both effective policy-making and implementation of tobacco control policies. We present knowledge and risk perceptions about smoking tobacco smoke exposure in Israel...
January 14, 2019: Israel Journal of Health Policy Research
Yael Bar-Zeev, Hagai Levine, Gil Rubinstein, Ihab Khateb, Carla J Berg
BACKGROUND: Philip Morris International's IQOS ("I Quit Ordinary Smoking") device has increasingly penetrated the global tobacco market. In Israel, among the first countries with IQOS in its market, the IQOS device is sold in specialty stores and online; the heat sticks - HEETS - are sold at traditional retailers. Advertising restrictions in many contexts including Israel have shifted industry marketing efforts to point-of-sale (POS). Given the nuances of IQOS and HEETS product distribution and the importance of POS marketing, we conducted a pilot study of IQOS POS marketing strategies...
January 14, 2019: Israel Journal of Health Policy Research
Yael Peled, Ron Loewenthal, Yigal Kassif, Eugenia Raichlin, Arwa Younis, Anan Younis, Eyal Nachum, Dov Freimark, Jacob Lavee
BACKGROUND: Ethnicity may affect graft longevity and recipient mortality after heart transplantation (HTx). We hypothesized that differences in ethnic origin between Arabs and Jews undergoing HTx in Israel may contribute to differences in long-term outcomes. METHODS: The study population comprised all 254 patients who underwent HTx between 1991 and 2017 in a tertiary medical center located in the center of Israel. Patients were categorized as either Jews (226 patients, 89%) or Arabs (28 patients, 11%)...
January 14, 2019: Israel Journal of Health Policy Research
Richard B Saltman
The ongoing information revolution has re-configured the policymaking arena for tax-funded health systems in Europe. A combination of constrained public revenues with rapid technological and clinical change has created a particularly demanding set of operational challenges. Tax-funded health systems face three ongoing struggles: 1) finding badly needed new public revenues despite inadequate GDP growth 2) channeling additional funds into new high-quality provider capacity 3) re-configuring the stasis-tied organizational structure and operations of existing public providers...
January 9, 2019: Israel Journal of Health Policy Research
Shai Luria, Daniel Talmud, Ido Volk, Meir Liebergall, Ronit Calderon-Margalit
BACKGROUND: Wrist and hand injuries are common and constitute a major economic burden. General injury prevention programs have failed to demonstrate a decrease in injury rates. We hypothesized that there are differences in injury patterns in culturally diverse subpopulations of a metropolitan area treated within the same medical system, which may partly explain the difficulties associated with injury prevention. METHODS: We conducted a survey of patients admitted to emergency departments of two hospitals in Jerusalem for wrist and hand injuries during a 3 month period...
January 9, 2019: Israel Journal of Health Policy Research
Shirli Werner, Carmit-Noa Shpigelman
Individuals with disabilities are entitled to equal access to information and communication technologies (ICT), including the Internet. The study to which this commentary refers has shown that over time (between 2003 and 2015), Internet access by persons with disabilities has increased, but a gap still exists between people with and without disabilities. One population that has been excluded from this study is that of individuals with intellectual disabilities. This is unfortunate because these individuals may face an even greater gap than others in access to the Internet...
January 9, 2019: Israel Journal of Health Policy Research
Anne H Gross, Jessica Driscoll, Laura Ma
The implementation of a new role in healthcare teams frequently emanates from emerging or changing needs in the care delivery system or expressed needs of clinicians, patients or caregivers. In this commentary on the experience of the nurse coordinator role in Israel we suggest based on similar experiences in the United States, that effective implementation is accomplished when the functions of the role are well delineated with respect to other members of the team and informed by the needs of patients, their caregivers and clinicians...
January 4, 2019: Israel Journal of Health Policy Research
Zachi Grossman, Gabriel Chodick, Talma Kushnir, Herman Avner Cohen, Gil Chapnick, Shai Ashkenazi
BACKGROUND: Burnout is an occupational disease expressed by loss of mental and physical energy due to prolonged and unsuccessful coping with stressors at work. A prior survey among Israeli pediatricians published in 2006 found a correlation between burnout and job structure match, defined as the match between engagement with, and satisfaction from, specific professional activities. The aims of the present study were to characterize the current levels of burnout and its correlates among community pediatricians, to identify changes over time since the prior survey, and to identify professional activities that may reduce burnout...
January 4, 2019: Israel Journal of Health Policy Research
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