Israel Journal of Health Policy Research最新文献

{"title":"IHR amendments and the \"pandemic agreement\" an Israeli perspective.","authors":"Shelly Kamin-Friedman, Nadav Davidovitch, Hagai Levine, Dorit Nitzan","doi":"10.1186/s13584-025-00676-6","DOIUrl":"10.1186/s13584-025-00676-6","url":null,"abstract":"<p><strong>Background: </strong>The 77th World Health Assembly in May 2024 agreed on several key amendments to the International Health Regulations (IHR) (2005), which are set to enhance global public health preparedness and response mechanisms. These amendments are part of a broader effort to integrate the lessons learned from the COVID-19 pandemic, seeking to create a more globally interconnected and rapid global response mechanism for future health crises, including a new Pandemic Agreement.</p><p><strong>Main body: </strong>Globally and in Israel, some voice their concern that the IHR amendments and the Pandemic Agreement could undermine a nation's sovereign right to manage its public health response, infringe on national autonomy, or impose obligations such as sharing resources like diagnostics, medicines, technology, or vaccines, which could be seen as detrimental to national interests. This manuscript describes the IHR amendments and the ongoing work on the Pandemic Agreement. It explains how the documents do not undermine national sovereignty and highlights the moral and utilitarian justifications for Israeli support of these global legal documents. From a moral perspective, Israel should be committed to promoting the value of global public health and universal health coverage at both the international and regional levels. From a utilitarian perspective, provisions ensuring access to products and information will assist Israel in preparing for and protecting against health threats originating in neighboring countries and globally. Moreover, asking countries to be better ready may promote awareness and actions of public health services in Israel, which has long suffered from budgetary and health workforce constraints.</p><p><strong>Conclusion: </strong>Israel must work to promote the endorsement of the Pandemic Agreement and the IHR amendments, as they are essential documents for addressing public health threats without compromising national sovereignty.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"14 1","pages":"13"},"PeriodicalIF":3.5,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626445","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":"Challenging selective contracting: reforms for enhancing patient empowerment in healthcare.","authors":"Gideon Leibner, Devorah Gold, Gabrielle Foreman, Shuli Brammli-Greenberg","doi":"10.1186/s13584-025-00673-9","DOIUrl":"10.1186/s13584-025-00673-9","url":null,"abstract":"<p><strong>Background: </strong>Health insurers and managed care organizations often limit patient choice to in-network care providers through selective contracting, involving procurement agreements with service providers or ownership of healthcare institutions. Patient choice reforms, i.e., reforms which expand hospital choice and reduce the power of the selective contracting, were introduced in a number of countries since the 1990s, in order to address long waiting times and enhance hospital competition based on quality, services, and availability. This study was motivated by Israel's 2023 health reform, which expanded patient choice by mandating broader hospital choice and enhancing transparency. This study examines reforms in selective contracting models in developed countries and assesses their impact on healthcare quality, accessibility, and socioeconomic disparities.</p><p><strong>Methods: </strong>A search was conducted on PubMed, Google Scholar, OECD Library, and European Observatory using keywords related to healthcare reform, provider choice, and selective contracting. The search was limited to English-language articles published since 2001.</p><p><strong>Results: </strong>Traditionally, NHS-based countries did not include patient choice in their systems. Reforms in countries like England and Portugal have since allowed patients choice between hospitals. In contrast, systems with multiple competing insurers, such as Germany, Switzerland, the Netherlands, and Israel, inherently incorporate some patient choice. Israel's 2023 health reform further broadened hospital choice, while maintaing selective contracting, and enhanced transparency. Patient choice is influenced by distance, quality, and availability. Patients often prefer nearby hospitals but will travel for higher quality care. Increased hospital competition generally improves care quality but may exacerbate socioeconomic disparities. Successful components of patient choice reforms include publishing comparative quality indicators and establishing national appointment scheduling systems. These initiatives increase transparency, improve patient decision-making, and drive hospital improvements.</p><p><strong>Conclusions: </strong>Expanding patient choice in healthcare enhances system efficacy and patient empowerment. However, addressing socioeconomic disparities is essential to ensure equitable access to high-quality care. Future policies should focus on tools and strategies that cater to all patient groups, including accessible and easily understood comprehensive quality assessments and national appointment scheduling systems. Further research should cover a wider range of healthcare systems to understand the challenges and opportunities in patient choice reforms comprehensively.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"14 1","pages":"12"},"PeriodicalIF":3.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573999","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":"Assessing the quality of studies funded by the Israel National Institute for Health Policy Research, 2010-2020.","authors":"Dan Even, Moshe Leshno, Avi Porath","doi":"10.1186/s13584-025-00672-w","DOIUrl":"10.1186/s13584-025-00672-w","url":null,"abstract":"<p><strong>Background: </strong>Research is the basis of advancement in health and wellbeing in modern societies. Our study aims to examine the funding policy of the Israel National Institute for Health Policy Research (NIHP), a national foundation responsible for assessing the impact of the national Health Insurance Law on health services in Israel. The study aims to evaluate the studies funded from 2010 to 2020, considering their publication in scientific literature and other channels that may influence decision-makers. We compare findings to a previous internal examination of studies funded by the NIHP during 1996-2014. Our paper presents an approach for measuring the impact of health policy research.</p><p><strong>Methods: </strong>All 378 studies funded by NIHP during the specified years were identified. Objective data were gathered by investigating scientific literature across three datasets: Web of Science (WOS), PubMed, and Google Scholar, including journal impact factor, quarterly index, and citation metrics. Concurrently, a questionnaire was developed to collect additional and subjective data from principal investigators of the funded research projects.</p><p><strong>Results: </strong>In the final sample of 364 studies funded by NIHP from 2010 to 2020, after 11 were cancelled, and 3 were duplicates. 436 publications were retrieved in peer-reviewed journals. The average time elapsed from funding to scientific publication was 4.65 years. Metric parameters for the top publications of 231 funded studies with at least one publication in peer-reviewed journals revealed an average journal impact factor of 5.97 points and an average of 7.82 citations according to WOS and 14 citations according to Google Scholar. A comparison to 459 funded studies from 1996 to 2014 found a twofold increase in the impact factor. Nearly half of the principal investigators reported some influence on policy processes in the questionnaires, and the majority of the studies were also reported in popular media outlets.</p><p><strong>Conclusions: </strong>The study provides an overview of the quality and potential influence of studies funded by NIHP, dedicated to supporting research in the field of health policy in Israel. Some of the findings are supported by results from similar inquiries. Several recommendations are introduced to enhance the quality and impact of the funded studies.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"14 1","pages":"10"},"PeriodicalIF":3.5,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558341","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":"Predictors of short stature in Israeli children aged 6-7 years: a retrospective cohort study.","authors":"Naama Fisch-Shvalb, Michal Yackobovitch-Gavan, Naomi Fliss-Isakov, Yair Morali, Nati Brooks, Moran Blaychfeld-Magnazi, Deena Rachel Zimmerman, Liora Lazar, Moshe Phillip, Ronit Endevelt","doi":"10.1186/s13584-025-00674-8","DOIUrl":"10.1186/s13584-025-00674-8","url":null,"abstract":"<p><p>There are differences in the rates of short stature (WHO height-z score < -2SD) between the various sectors in Israeli children aged 6-7 years, with higher rates in the ultraorthodox Jewish population. We aimed to: (a) Compare the anthropometric data at 0-2 years of age and the obstetric and demographic data of children with short stature at 6-7 years of age with those of children with normal height. (b) Assess risk factors for short stature at the age of 6-7 years. (c) Evaluate the impact of clinical and socioeconomic factors on linear growth from birth to the age of 6-7 years. This was a retrospective cohort study. Anonymized anthropometric data measured at the first grade of school during 2015-2019 were collected from the Ministry of Health records. The participants were stratified into sectors according to the affiliation of their school. Retrospective growth and sociodemographic data were extracted for each child from the national birth registry and Maternal Child Health Clinics files. The cohort included 368,088 children, with a median age of 6.7 years (IQR 6.3,7.0). Short stature was more prevalent in ultraorthodox Jewish boys (3.8%) and girls (3.2%), and least prevalent in Arab boys (0.8%) and girls (0.7%) compared with all other sectors (P < 0.001). The rate of stunting in Bedouin children was similar to that in the general population (1.6%). In a logistic regression model, the variables that predicted short stature at the age of 6-7 years were female sex, longer gestation, lower height z-score at 2 months of age, birth weight < 90th percentile, being in the ultraorthodox Jewish sector, and a smaller change in height z-score until 2 years of age. Growth gaps between different sectors of school-aged Israeli children emerge during the first 2 years of life. The most vulnerable population for stunting is the ultraorthodox population. Public health services, including Maternal Child Health clinics and primary caregivers, should prioritize this group and closely monitor for growth faltering during the first and second years of life.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"14 1","pages":"11"},"PeriodicalIF":3.5,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567623","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":"An individual's trust in government is a major determinant in the decision to voluntarily join a public health initiative.","authors":"Orit Golan, Carmit Satran, Shiran Bord","doi":"10.1186/s13584-025-00671-x","DOIUrl":"10.1186/s13584-025-00671-x","url":null,"abstract":"<p><strong>Background: </strong>Recently, there has been a growing trend of incorporating technology using health applications by official organizations such as health organizations and governmental bodies. In response to the COVID-19 pandemic, Israel implemented a health application to be voluntarily downloaded by citizens (VA). Additionally, the Israeli authorities used mandatory mobile tracking to monitor citizens' movements (GT). The current study aims to identify the factors associated with individuals' decisions to download the voluntary contact-tracing app. We hypothesized that (a) attitudes toward GT will mediate the relations between trust in the healthcare system and downloading VA, and (b) attitudes toward GT will mediate the relations between the perceived COVID-19 threat and downloading VA.</p><p><strong>Methods: </strong>Data were collected among 741 respondents who completed an online survey on July 19-21, 2020. The survey was designed to represent the diversity of the Israeli population. A logistic regression was calculated with downloading VA as the dependent variable and trust in the healthcare system, perceived threat and attitudes toward GT as independent variables. Then, the extent to which attitudes toward GT mediated the associations between trust in the healthcare system and downloading VA and between the perceived threat and downloading the voluntary app was assessed using the Process procedure.</p><p><strong>Results: </strong>The findings reveal that 47.1% of respondents perceive governmental tracing as an invasion of privacy, while 24.4% report that it increased their sense of security. About a third report having downloaded the voluntary app. Both research hypotheses were supported; attitudes played a mediating role in the relationship between an individual's level of trust and an individual's level of perceived threat and behavior, i.e., higher trust and higher perceived COVID-19 threat were associated with more favorable attitudes towards GT, which was associated with more substantial odds of downloading VA.</p><p><strong>Conclusions: </strong>The results emphasize the crucial importance of public trust. Building trust with the public is essential to encourage voluntary actions that ultimately benefit public health. Achieving and maintaining the public's trust requires addressing concerns about the potential misuse of government power and fostering an environment that promotes voluntary participation and engagement.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"14 1","pages":"9"},"PeriodicalIF":3.5,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426329","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":"Food supplied to Gaza during seven months of the Hamas-Israel war.","authors":"Naomi Fliss-Isakov, Dorit Nitzan, Moran Blaychfeld Magnazi, Joseph Mendlovic, Sharon Alroy Preis, Gilad Twig, Aron M Troen, Ronit Endevelt","doi":"10.1186/s13584-025-00668-6","DOIUrl":"10.1186/s13584-025-00668-6","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The ongoing Hamas-Israel war has put the civilian population in Gaza at risk of severe food and nutrition insecurity. Our goal was to provide objective, verifiable data to ascertain amounts and nutritional content of food supplied to Gaza through Israeli border crossings from January to July 2024. We aimed to assess their compliance with Sphere international humanitarian standards for food security and nutrition maintenance in crisis affected populations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We obtained the registry of all food supplied to Gaza via air drops and land crossings from Israel's Coordinator of Government Activities in the Territories (COGAT) from January to July 2024. This registry itemizes daily food shipments, their items and estimated weights. Food items in shipments were categorized, quantified, assessed and summed for energy (kcal), protein (g), fat (g), iron (mg) content, based on food labels and composition tables. We then calculated supply per capita per day supplied to the the Gaza Strip, according to the most recent population census of Gaza. Finally, we compared it to the Sphere standards for population food security.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Adjusting for projected food losses, a net total of 478,229 metric tons of food was supplied to Gaza over the seven consecutively studied months. The average amount of energy available per person per day was 3,004 kcal, with 98 g of protein (13% of energy), 61 g of fat (18% of energy), and 23 mg of iron. Except for February, when entries dropped from January, there was a steady increase in the tonnage, energy, macronutrients and iron content of donated foods supplied to Gaza registered by COGAT. The amounts of energy, protein, and fat, but not dietary iron, in food crossing the border into Gaza consistently exceeded Sphere standards after making conservative adjustment for high food loss and the age distribution of the Gazan population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study assessed food deliveries by type, amount and nutrient composition, supplied to Gaza from January to July 2024. We found that, except in February, food crossing the borders into Gaza exceeded per capita minimal requirements for humanitarian aid. While reliable data do not exist for critical dimensions of food access and consumption across Gaza, these estimates suggest that adequate amounts of nutritious food were being transported into the Gaza Strip during most of the 1st half of 2024. We propose that with increased cooperation of all partners and shared efforts to overcome barriers, communication and data sharing, the UN Food Security Cluster, COGAT and humanitarian assistance agencies can develop a comprehensive, continually updated database to gauge food availability, access, nutritional value, and gaps to address, especially in the areas most disrupted by conflict in Gaza. This will also help ensure that food donations supplied to Gaza reach populations in greatest need","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"14 1","pages":"8"},"PeriodicalIF":3.5,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11818336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143410897","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":"Arab representation in Israeli healthcare professions: achievements, challenges and opportunities.","authors":"Bruce Rosen, Sami Miaari","doi":"10.1186/s13584-024-00663-3","DOIUrl":"10.1186/s13584-024-00663-3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Israel is a multiethnic society with a population of 9.8 million at the end of 2023. Israeli Arabs (i.e., Arab Palestinian citizens of Israel) account for 21% of the Israel's overall population, 22% of its working age population and 16% of the employed population. This study has several objectives: (1) To provide an overview of the current representation of Israeli Arabs in four key health care professions (medicine, nursing, dentistry, and pharmacy) in terms of employment, licensure, and professional studies; (2) To document changes in those parameters over the past decade, subject to limitations of data availability; (3) To provide a broader context on the employment of Israeli Arabs; (4) To explore the policy implications of the key findings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Estimates of employment levels are based on the Labor Force Survey (LFS) of the Central Bureau of Statistics (CBS). Data on licensure (i.e., professional qualification) and place of professional studies were extracted from the Ministry of Health report series entitled \"The Health Care Professions\". Data on enrollment in degree programs in Israel was provided by the Council of Higher Education. Important background information was elicited from relevant policy documents and policy experts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In 2023, among employed Israelis up to age 67, Arabs constituted approximately one-quarter of Israel's physicians (25%), nurses (27%), and dentists (27%), and half of Israel's pharmacists (49%). These percentages are substantially higher than they were in 2010, with the increase being particularly marked in the case of physicians (25% versus 8%). The number of new licenses granted annually increased significantly between 2010 and 2022 for both Arabs and Jews in each of the professions covered. The percentage of newly licensed professionals who are Arab increased substantially among physicians and nurses, while remaining stable among dentists and pharmacists. In medicine, dentistry, and pharmacy, many of the licensed Arab health professionals had studied outside of Israel; this phenomenon also exists for nursing but is less widespread there. In the 2022/3 academic year, the percentage of first-degree students in Israeli colleges and universities who were Arab was 70% in pharmacy, 33% in nursing, 23% in dentistry, and 9% in medicine. Between 2012/3 and 2022/3 the percentage of first-degree students who are Arab increased substantially for pharmacy, declined slightly for nursing, and declined substantially for medicine and dentistry.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Arab professionals play a substantial and recently increased role in the provision of health care services in Israel. It is important to recognize, appreciate, and maintain this substantial role. Moreover, its potential as a model for sectors other than health care should be explored. To build on achievements to date, and to promote continued progress, policymakers","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"14 1","pages":"7"},"PeriodicalIF":3.5,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081469","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":"Wake-up call for recovery: a paradigm shift to address the deep crisis in Israel's public mental health services in the shadow of October 7, 2023.","authors":"Amir Krivoy, Gadi Rosenthal","doi":"10.1186/s13584-025-00670-y","DOIUrl":"10.1186/s13584-025-00670-y","url":null,"abstract":"<p><strong>Background: </strong>The events of October 7, 2023, and the subsequent war have starkly exposed the shortcoming of Israel's public mental health system. This system, already strained by years of underfunding and the COVID-19 pandemic, was unprepared for the surge in mental health needs resulting from these traumatic events. This paper outlines the systemic failures and proposes a comprehensive overhaul reform towards an integrative community-based, recovery-oriented mental health service.</p><p><strong>Main body: </strong>Israel's mental health crisis is exacerbated by four converging vectors: a global diagnostic crisis in psychiatry, insufficient biological treatments, chronic underfunding, and a fragmented service model. Diagnostic practices, centered on outdated classifications, fail to address the complexity of severe mental illnesses, resulting in imprecise diagnoses and insufficient treatments. Despite the advent of psychopharmacology, significant advancements in drug efficacy are lacking, with recovery rates stagnating or declining. Financially, mental health in Israel receives only 5.2% of the health budget, far below the 10-16% seen in high-GDP Western countries. The community mental health services reform in 2015 lack effective oversight and incentives, leading to long wait times and inadequate care. Additionally, the fragmentation among funding entities-HMOs, Ministry of Health, and Ministry of Welfare-hampers coordinated care and comprehensive service delivery.</p><p><strong>Conclusion: </strong>The proposed solution involves shifting from a hospital-biomedical -based to an integrated community-based model, emphasizing recovery over symptom management, based on regional mental health centres as hubs of services. This requires significant investment in community mental health teams, crisis intervention, home treatment, and integrated services. Early intervention, technology utilization, economic incentives for community-based care, and patient and family involvement are crucial components. This transformation aims to create a holistic, efficient, and patient-centered mental health system, better equipped to handle future challenges and reduce the societal and economic burdens of mental illness in Israel.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"14 1","pages":"6"},"PeriodicalIF":3.5,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068764","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":"Vision impairment in boys recruited to the iREAD study.","authors":"Jonathan Levine, Ravid Doron, Lisa A Ostrin, Einat Shneor","doi":"10.1186/s13584-025-00667-7","DOIUrl":"10.1186/s13584-025-00667-7","url":null,"abstract":"<p><strong>Background: </strong>Uncorrected refractive error is reported to be the most common cause globally of vision impairment in school age children. However, little is known about the extent of uncorrected refractive error in Israel. The purpose of this study was to investigate the prevalence of vision impairment in schoolchildren recruited for the Israel Refraction, Environment, And Devices (iREAD) Study.</p><p><strong>Methods: </strong>Healthy boys, ages 5-13 years, were recruited to participate in the iREAD Study. Parents first answered a questionnaire to exclude children with a known history of amblyopia, strabismus, or hyperopia. A comprehensive eye exam was then performed. Presenting visual acuity < 6/12 was defined as vision impairment. Myopia and hyperopia were defined as cycloplegic spherical equivalent refraction  ≤ - 0.50 D, and ≥  + 0.50 D, respectively, and astigmatism as ≤ - 0.75 D. Amblyopia was defined as best corrected visual acuity ≤ 6/12 in at least one eye in the absence of any ocular pathology. Descriptive statistics were used to calculate the prevalence of each refractive error and amblyopia.</p><p><strong>Results: </strong>Two hundred five boys (average age 8.8 ± 1.7 years) presented for a comprehensive eye exam. The prevalence of vision impairment at initial presentation was 22.9% (N = 47), with 16.1% (N = 33) and 6.8% (N = 14) for both eyes and one eye, respectively. Of the children with vision impairment, 36.2% (N = 17) were wearing habitual correction. Of the children with vision impairment, 97.9% (N = 46) had refractive error, with 85.1% (N = 40) being myopic and 12.8% (N = 6) being hyperopic. In addition, 36.2% (N = 17) with vision impairment had astigmatism. Most children with vision impairment (N = 43) achieved good vision with refractive correction. However, amblyopia was observed in 2.0% (N = 4) of the children.</p><p><strong>Conclusions: </strong>A high prevalence of vision impairment was observed, primarily due to uncorrected or undercorrected refractive error. Children with amblyopia and/or hyperopia presented despite a parent questionnaire to exclude children with these conditions. Findings suggest that many parents are unaware of their children's visual and refractive status, even for children who already have glasses. In conclusion, improvements to the current system in Israel of vision screenings in first grade should be made to help insure children in need receive adequate follow-up throughout their education.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"14 1","pages":"5"},"PeriodicalIF":3.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053928","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 Israel's Medical Administration subspecialty, 1987-2022.","authors":"Yoel Angel, Hadar Goldshtein, Nevo Barel, Gil Fire, Michael Halberthal, Adi Niv-Yagoda","doi":"10.1186/s13584-025-00666-8","DOIUrl":"10.1186/s13584-025-00666-8","url":null,"abstract":"<p><strong>Background: </strong>Israel is unique in offering a formal subspecialty in Medical Administration and mandating it for physicians applying for senior roles. Data on the prevalence and characteristics of these specialists are limited.</p><p><strong>Methods: </strong>The national registry of licensed physicians was used to identify all living physicians who completed the Medical Administration subspecialty by December 31, 2022. Data on year of medical licensing, city of residence, and list of additional recognized specialties along with their respective date of completion were extracted. Websites of key public health organizations were sampled to identify qualifications of persons in senior leadership positions.</p><p><strong>Results: </strong>Since 1987, 277 physicians have completed the Medical Administration subspecialty, with a significant increase in annual certifications from 4.5 in 2015 (interquartile range [IQR] 4-6) to 13 (IQR 10.5-15) in 2022 (p < 0.001). Specialists completed the subspecialty a median of 18 years (IQR 13-21) post-licensing, with 269 physicians (97.1%) holding additional specialties, primarily in Internal Medicine, Pediatrics, Family Medicine, or Public Health. Compared to the general physician population, some base specialties like Public Health are over-represented while others, like Anesthesiology, are under-represented. Only 40 (14.4%) specialists reside outside major metropolitan areas. Nineteen (61.3%) general hospital CEOs, 2 (20%) psychiatric hospital CEOs, 13 (35.1%) Ministry of Health and 4 (7.8%) Sick Fund executives are specialists in Medical Administration (p < 0.005).</p><p><strong>Conclusions: </strong>The steady growth in the number of specialists in Medical Administration demonstrates the sustainability and scalability of this model, which may serve as a template for other healthcare systems. However, the limited representation of these specialists in senior roles of some organizations, and their concentration within certain specialties and regions, indicates areas for policy attention to enhance leadership diversity and reduce healthcare disparities.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"14 1","pages":"3"},"PeriodicalIF":3.5,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980420","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}