Israel Journal of Health Policy Research最新文献

{"title":"Digital emergency routing: analysis of feasibility, utilization, and equity implications.","authors":"Osnat Bashkin, Tamar Shalom, Ilan Yehoshua, Limor Adler","doi":"10.1186/s13584-026-00761-4","DOIUrl":"10.1186/s13584-026-00761-4","url":null,"abstract":"<p><strong>Background: </strong>Digital emergency care applications offer potential to reduce delays, enhance triage, and improve care coordination, yet evidence remains limited on their real-world implementation at scale. Maccabi Healthcare Services developed Maccabi-RED, a mobile application allowing patients to request urgent community-based care as an alternative to hospital emergency department visits. This study examines the implementation and utilization of Maccabi-RED during 2020-2023, aiming to describe demographic and clinical characteristics of patients initiating emergency care requests, identify factors associated with request approval and successful routing to community-based care and examine healthcare utilization patterns following app-initiated requests.</p><p><strong>Methods: </strong>This retrospective study analyzed de-identified electronic health record data from Maccabi Healthcare Services, including all patient-initiated emergency care requests through the Maccabi-RED application between January 2020 and December 2023. The study included 94,795 requests from 77,508 patients. We extracted demographic and clinical variables and examine patterns of subsequent healthcare utilization in the week following app-initiated emergency care requests, comparing approved versus non-approved requests.</p><p><strong>Results: </strong>During the study period, 51.6% of requests were approved, resulting in urgent community clinic appointments. Service utilization increased substantially from 11,058 requests in 2020 to 36,532 in 2023. Approved requests were more common among older patients and those with chronic conditions. Emergency type strongly influenced approval rates, with foreign body cases showing substantially higher approval odds than orthopedic cases. Geographic, ethnic, and socioeconomic disparities in approval rates were observed. In adjusted analyses, approved requests were associated with lower 7-day healthcare utilization, including fewer primary care physician visits and reduced odds of hospital emergency department and emergency medical center visits.</p><p><strong>Conclusions: </strong>The Maccabi-RED application demonstrates feasibility of scaling patient-initiated digital emergency routing, with potential to reduce downstream acute care utilization. However, observed approval disparities across age groups, geographic regions, and socioeconomic strata indicate that digital maturity alone does not guarantee equitable access. These findings underscore the importance of embedding equity considerations in system design, monitoring protocols, and capacity planning. Future development, including artificial intelligence-enabled decision support, should prioritize transparency and algorithmic fairness to improve performance without amplifying existing health inequities.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"15 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13151258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Willingness to donate biosamples to a national biobank in Israel: a population-based cross-sectional survey.","authors":"Adelina Ovcharenko, Yehudit Cohen, Shimon A Reisner","doi":"10.1186/s13584-026-00762-3","DOIUrl":"https://doi.org/10.1186/s13584-026-00762-3","url":null,"abstract":"<p><strong>Background: </strong>Israel is advancing large genetic and longitudinal studies in personalized medicine through national digital health initiatives. MIDGAM, the Israeli national biobank established in 2014, provides the core biosample and data infrastructure enabling this research. We investigated the willingness to donate samples and linked clinical data for research purposes, and examined preferences regarding the receipt of research-derived information, including incidental findings.</p><p><strong>Methods: </strong>A structured, self-administered questionnaire was distributed electronically to a representative sample of the Israeli population. Participants were asked about their willingness to donate biosamples and linked data, and their opinions regarding receiving results including incidental findings. The data were analyzed by sociodemographic and health characteristics.</p><p><strong>Results: </strong>The survey included 1,607 respondents. 52% were willing to donate biosamples, and 40% were also willing to link them with their medical records and to receive incidental results (84.6% of those willing to donate). Individuals most willing to donate and receive research findings, were non-Ultra-Orthodox Jewish, secular, male, aged 30 to 49 years with post-secondary/academic education and above-average income. Additionally, respondents characterized by better general health, being physically active, and absence of chronic or severe illness were more willing to donate biosamples. The main barriers to biosample donation were concerns about data leakage, privacy violations and lack of understanding of the donation purpose.</p><p><strong>Conclusion: </strong>Israel's biosample donation landscape mirrors global patterns, with notable sectorial and demographic disparities. Higher socioeconomic status and health engagement increase willingness to donate, while privacy concerns and the perceived burden of continued involvement reduce participation.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"15 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13147693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in socio-demographic disparities in COVID-19 vaccine uptake by vaccine dose and time after the introduction of COVID-19 vaccination in Israel: epidemiological and policy analysis study.","authors":"Hala Manaa, Dani Cohen, Khitam Muhsen","doi":"10.1186/s13584-026-00758-z","DOIUrl":"10.1186/s13584-026-00758-z","url":null,"abstract":"<p><strong>Background: </strong>Evidence on sociodemographic disparities in COVID-19 booster vaccine uptake remains limited. We examined disparities in COVID-19 vaccine uptake among the Arab, ultraorthodox Jewish, and general Jewish populations in Israel (January 2021-August 2022), focusing on vaccine dose, community characteristics, and policy analysis.</p><p><strong>Methods: </strong>Publicly available COVID-19 data from 135 cities (≥ 10,000 residents) were analyzed. Cumulative vaccine uptake by dose was assessed by age and population group across 3 periods (period-1: to June 2021, period-2: to December 2021, period-3: to August 2022). Policy analysis was conducted using Walt and Gilson's Policy Triangle framework, drawing on the literature, government reports, official websites, and media coverage.</p><p><strong>Results: </strong>Data from 76 predominantly non-ultraorthodox Jewish cities, 10 ultraorthodox Jewish cities, and 49 Arab cities were included. Compared to the general Jewish population, dose 1 uptake was lower in ultraorthodox (incidence rate ratio (IRR) = 0.51, 95% CI 0.26-0.99) and Arab cities: IRR = 0.76, 0.53-1.09), with similar gaps for dose 2. Disparities widened with boosters: for dose 3, uptake was significantly lower in ultraorthodox cities (period-2 IRR = 0.38 [0.20-0.74], period-3: IRR = 0.39 [0.20-0.75]); and Arab cities (period-2 IRR = 0.55 [0.38-0.79], period-3 IRR = 0.56 [0.39-0.81]). For dose 4, gaps were largest in adults aged ≥ 60 years (ultraorthodox: IRR = 0.24 [0.12-0.47]; Arab: IRR = 0.15 [0.10-0.22]). Higher socioeconomic status was consistently associated with uptake, particularly for boosters. The peripherality index was associated with lower dose 4 uptake, suggesting geographic disparities and access barriers. Policy analysis highlighted Israel's rapid mass vaccination rollout and evidence-based booster adoption, but also declining booster uptake and widening sociodemographic inequities. The primary campaign relied on centralized mass vaccination efforts and intensive public messaging, achieving high coverage, while the booster phase was mainly integrated into existing infrastructure, with more targeted outreach and reduced media emphasis, shifting from infection prevention to severe-disease prevention policy.</p><p><strong>Conclusions: </strong>Persistent disparities in COVID-19 vaccine uptake widened during the booster phase in Israel. While rapid, centralized rollout achieved high initial coverage, sustaining equitable uptake proved challenging. These findings highlight the need for ongoing, equity-focused strategies, including targeted outreach and culturally tailored interventions throughout all phases of public health emergencies, particularly in the long-term phase, to strengthen existing healthcare infrastructure.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"15 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The oath and accountability: Insights From The 2nd Annual IDF Medical Corps Bioethics Conference during wartime.","authors":"Avi Shina, Maya Peled Raz, Noa Revivo Tuchner","doi":"10.1186/s13584-026-00755-2","DOIUrl":"10.1186/s13584-026-00755-2","url":null,"abstract":"<p><p>The Israel Defense Forces Medical Corps (IDF MC) assumes statutory responsibility for the health of personnel across all military branches and services within the IDF. Since the outbreak of the \"Swords of Iron\" war in October 2023, the Corps has operated under unprecedented conditions, treating casualties across multiple fronts. The prolonged conflict has posed immense challenges, raising complex ethical dilemmas that demand real-time processing. In July 2025, the IDF MC convened its second annual bioethics conference, \"The Oath and Accountability,\" gathering approximately 200 military healthcare leaders. The conference utilized a comparative analysis of the Medical Corps Oath vis-à-vis civilian codes to examine wartime realities. Discussions focused on real-life dilemmas presented by field personnel, exploring the profound tension between the dual identities of the \"soldier-healer\" and the conflict between clinical duty and operational necessity. Drawing on theoretical frameworks of ethical leadership, the conference underscored that maintaining openness to discuss ethical issues is a critical mechanism for resilience. Key themes included the cultivation of professional integrity and the exercise of \"ethical voice\" within a hierarchy. The conference concluded that ethical engagement transforms the medical officer from a technical provider into a strategic advisor on values in combat, reaffirming that a robust ethical compass is not a peacetime luxury but a vital operational strength and necessity.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"15 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13130532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health insurance literacy in Israel: gaps between knowledge and use in a universal healthcare system.","authors":"Reut Ron, Paula Feder-Bubis, Moriah E Ellen","doi":"10.1186/s13584-026-00759-y","DOIUrl":"10.1186/s13584-026-00759-y","url":null,"abstract":"","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"15 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13085595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Privatization of ophthalmology: unveiling disparities in the surgical arena.","authors":"Asaf Israeli, Keren Hod, Rachel Shemesh, Tamara Wygnanski-Jaffe, Eedy Mezer","doi":"10.1186/s13584-026-00756-1","DOIUrl":"10.1186/s13584-026-00756-1","url":null,"abstract":"","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"15 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13054969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants, patterns, and gaps in patient safety and quality of care research in Israel: a scoping review.","authors":"Merav Ben Natan","doi":"10.1186/s13584-026-00749-0","DOIUrl":"10.1186/s13584-026-00749-0","url":null,"abstract":"","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"15 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13047777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When practice outpaces policy: Whatsapp use among nursing and medical staff in Israeli hospitals.","authors":"Drora Ben Michael Vinker, Maya Peled-Raz","doi":"10.1186/s13584-026-00754-3","DOIUrl":"10.1186/s13584-026-00754-3","url":null,"abstract":"","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"15 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13045068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The framework and best practices of emergency medical teams: lessons learned from Israel's international field hospital response.","authors":"Evan Avraham Alpert, Giora Weiser, Deganit Kobliner-Friedman, Mitchell J Schwaber, Ami Mayo, Reuven Kedar, Nehemia Blumberg, Ofer Merin","doi":"10.1186/s13584-026-00751-6","DOIUrl":"10.1186/s13584-026-00751-6","url":null,"abstract":"","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"15 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13014817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Who benefits from multidisciplinary care in functional somatic disorders? Identifying cost-effective patient selection through diagnostic classification groups.","authors":"Oded Hammerman, Alon Rasooly, Dan Greenberg, Talma Kushnir, Erez Yaakobi, Yacov Ezra","doi":"10.1186/s13584-026-00750-7","DOIUrl":"10.1186/s13584-026-00750-7","url":null,"abstract":"<p><strong>Background: </strong>Functional Somatic Disorders (FSD) significantly impact patients' quality of life while placing a substantial economic burden on healthcare systems. Identifying which patients achieve reductions in healthcare costs through multidisciplinary care remains crucial for optimizing resource allocation.</p><p><strong>Methods: </strong>A retrospective analysis examined healthcare utilization and costs during the year preceding and the year following patients' initiation of treatment at a specialized, multidisciplinary clinic in Israel. The clinic combined medical care with mind-body therapies - including cognitive behavioral therapy, hypnotherapy, and physiotherapy. Using baseline characteristics, patients were divided into Diagnostic Classification Groups (DCG). A multivariable analysis was performed to ascertain the impact of DCG on annual, average changes in healthcare utilization and costs after treatment.</p><p><strong>Results: </strong>Data from N = 685 patients were analyzed. Reduced healthcare utilization and costs were observed among approximately 56% of the population receiving multidisciplinary care. Mean annual cost reductions were 1,367 ILS per patient. Specifically, significant reductions were observed in hospitalizations (-1,723 ILS) and diagnostic procedures (-495 ILS). Patients with simple FSD and stress-exacerbated diseases showed significant cost reductions (P < 0.05), while those with organic disease or difficult FSD did not demonstrate significant changes. Analysis by DCG revealed that baseline diagnostic classification significantly predicted cost reduction.</p><p><strong>Conclusion: </strong>Healthcare utilization and costs were reduced among FSD patients receiving multidisciplinary treatment, with outcomes varying by diagnostic classification. Baseline diagnostic classification reliably predicted treatment cost-effectiveness, underlining the economic value of collaborative care for patients with simple functional disorders and stress-exacerbated diseases. These diagnostic patterns provide healthcare policymakers with selection criteria for multidisciplinary programs and inform the development of tailored interventions.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"15 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12997945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147475686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}