Israel Journal of Health Policy Research最新文献

{"title":"Crisis management for Patient Safety Officers: lessons learned from the Covid-19 pandemic.","authors":"Ilya Kagan, Dana Arad, Riki Aharoni, Yossi Tal, Yaron Niv","doi":"10.1186/s13584-023-00577-6","DOIUrl":"10.1186/s13584-023-00577-6","url":null,"abstract":"<p><strong>Background: </strong>There is no consensus for the role definition for Patient Safety Officers (PSOs) in healthcare during pandemics or other crises as opposed to their routine activities. This study aimed to examine the contribution of personality traits and systemic factors on the performance of PSOs during the pandemic, and to compare these variables during the first and third waves of the Covid-19 pandemic in Israel.</p><p><strong>Methods: </strong>This cross-sectional study invited 117 PSOs to complete a questionnaire addressing their role during the Covid-19 pandemic. The questionnaire included items concerning: Personal and socio-demographic characteristics; Uncertainty; Personal initiative; Burnout; Professional functioning; Patient Safety and Risk Management policies and practices; Organizational functioning; and Personal Involvement in risk management activities. Qualitative data was collected by two open-ended questions.</p><p><strong>Results: </strong>A total of 78 PSOs (67%) completed the questionnaire. The results revealed that many PSOs reduced their involvement in risk management processes or even left their position temporarily in order to return to their primary specialization as clinicians. Only 51.3% and 57.7% reported practicing risk management in the first and third waves, respectively. The three main factors that kept PSOs functioning were managerial support, mobilization of their team, and the belief in the importance of their position.</p><p><strong>Conclusions: </strong>A crisis generates uncertainty, a plethora of frequent and urgent tasks, and the need to adapt policy to changing circumstances and to the increased risks. The risk manager must be a member of the crisis management team and participate in every important discussion in order to represent essential staff and patient safety issues and ensure that these are fully addressed already in the early stages of planning.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"12 1","pages":"29"},"PeriodicalIF":4.5,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10472639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10165922","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":"Healthcare policy changes in an era of health workforce shortage.","authors":"Yoel Angel, Gil Fire","doi":"10.1186/s13584-023-00576-7","DOIUrl":"10.1186/s13584-023-00576-7","url":null,"abstract":"<p><p>In their recent IJHPR article, Wimpfheimer and colleagues outline the implications for the field of anesthesia of two major healthcare policy changes in Israel: The Yatziv Reform in licensing foreign medical graduates and the efforts to reduce residents' on-call shift duration. We argue that these reforms are necessary to strengthen the healthcare workforce and improve the quality of care in the long term, even though they may limit the availability of healthcare personnel for several years, particularly in the field of anesthesia. In this commentary, we examine the background to these policy changes, their likely impact on the medical workforce in Israel in general, and propose steps to reconcile these reforms with the global and national shortage of physicians. We urge policymakers to allocate the required resources and begin preparing for an era of continuous mismatch between physician supply and demand, which will necessitate creative solutions, increased reliance on technology, and the introduction of paramedical professionals to help offload tasks and better utilize the scarce physician workforce.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"12 1","pages":"28"},"PeriodicalIF":4.5,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10413592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10349862","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":"To charge or not to charge: reducing patient no-show.","authors":"Gideon Leibner, Shuli Brammli-Greenberg, Joseph Mendlovic, Avi Israeli","doi":"10.1186/s13584-023-00575-8","DOIUrl":"10.1186/s13584-023-00575-8","url":null,"abstract":"<p><strong>Background: </strong>In order to reduce patient no-show, the Israeli government is promoting legislation that will allow Health Plans to require a co-payment from patients when reserving an appointment. It is hoped that this will create an incentive for patients to cancel in advance rather than simply not show up. The goal of this policy is to improve patient access to medical care and ensure that healthcare resources are utilized effectively. We explore this phenomenon to support evidence-based decision making on this issue, and to determine whether the proposed legislation is aligned with the findings of previous studies.</p><p><strong>Main body: </strong>No-show rates vary across countries and healthcare services, with several strategies in place to mitigate the phenomenon. There are three key stakeholders involved: (1) patients, (2) medical staff, and (3) insurers/managed care organizations, each of which is affected differently by no-shows and faces a different set of incentives. The decision whether to impose financial penalties for no-shows should take a number of considerations into account, such as the fine amount, service type, the establishment of an effective fine collection system, the patient's socioeconomic status, and the potential for exacerbating disparities in healthcare access. The limited research on the impact of fines on no-show rates has produced mixed results. Further investigation is necessary to understand the influence of fine amounts on no-show rates across various healthcare services. Additionally, it is important to evaluate the implications of this proposed legislation on patient behavior, access to healthcare, and potential disparities in access.</p><p><strong>Conclusion: </strong>It is anticipated that the proposed legislation will have minimal impact on attendance rates. To achieve meaningful change, efforts should focus on enhancing medical service availability and improving the ease with which appointments can be cancelled or alternatively substantial fines should be imposed. Further research is imperative for determining the most effective way to address the issue of patient no-show and to enhance healthcare system efficiency.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"12 1","pages":"27"},"PeriodicalIF":4.5,"publicationDate":"2023-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10408071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9965144","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":"\"A picture is worth a thousand words\": smoking in multi-unit housing in Israel.","authors":"Mitchell Zeller","doi":"10.1186/s13584-023-00574-9","DOIUrl":"https://doi.org/10.1186/s13584-023-00574-9","url":null,"abstract":"<p><p>A brief commentary on the need for policy change by the Israeli government to address the problem of tobacco smoke incursion in multi-unit housing. The commentary also includes a call for enhanced products, programs, and services to help smokers in Israel quit.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"12 1","pages":"26"},"PeriodicalIF":4.5,"publicationDate":"2023-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10405405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9972237","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":"Tobacco smoke incursion into private residences in Israel: a cross-sectional study examining public perceptions of private rights and support for governmental policies.","authors":"Noa Theitler, Vaughan W Rees, Maya Peled-Raz, Michal Bitan, Laura J Rosen","doi":"10.1186/s13584-023-00573-w","DOIUrl":"10.1186/s13584-023-00573-w","url":null,"abstract":"<p><strong>Background: </strong>Tobacco smoke incursion (TSI) into private residences is a widespread problem in many countries. We sought to assess the prevalence of self-reported TSI and public attitudes about TSI in Israel, a country with a relatively high smoking prevalence and high population density.</p><p><strong>Methods: </strong>We conducted a random digit dial survey among residents in Israel (N = 285) in 2017, which examined the frequency, source, correlates of, and attitudes towards TSI and potential regulatory options. The cooperation rate was 63.9%.</p><p><strong>Results: </strong>Among respondents, 44.7% reported ever experiencing home TSI, with higher exposure among residents of multi-unit housing (MUH) (MUH versus private homes: aOR (Adjusted Odds Ratio): 3.60, CI (Confidence Interval): [1.96, 6.58], p < .001). Most respondents (69.8%), including nearly half of smokers, prioritized the right of individuals to breath smoke-free air in their apartments over the right of smokers to smoke in their apartments. Women and non-smokers were more likely to support the right to breathe smoke-free air (Women versus men: aOR: 2.77 CI: [1.48, 5.16], p = .001; Nonsmokers versus smokers: aOR: 3.21 CI [1.59, 6.48], p = .001). However, only about a quarter (24.8%) of respondents who ever experienced TSI raised the issue with the neighbor who smoked, the neighbor's landlord, or the building committee. The vast majority (85.2%) of all respondents, including three-quarters of smokers, supported smoke-free legislation for multi-unit housing (MUH), with those ever-exposed to TSI and non-smokers more likely to support legislation (ever-exposed versus never-exposed aOR = 2.99, CI [1.28, 6.97], p = 0.011; nonsmokers versus smokers aOR = 3.00, CI [1.28, 7.01], p = 0.011).</p><p><strong>Conclusions: </strong>Among study participants, tobacco smoke incursion was a common, yet unwelcome experience. Most respondents believed that the right to breathe smoke-free air in one's apartment superseded that of neighbors to smoke anywhere in their home, and most supported legislation to prevent TSI. Though further study is needed to understand better TSI and effective methods for its prevention, our findings suggest that policy interventions, including legal action at the level of the Supreme Court and/or the Knesset, are needed. Regulation, policy initiatives and campaigns to denormalize smoking in proximity to other people and private residences globally could reduce the scope of this widespread problem, protect individuals from home TSI, and improve population health.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"12 1","pages":"25"},"PeriodicalIF":4.5,"publicationDate":"2023-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10362702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9955227","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":"High out‑of‑pocket spending and financial hardship at the end of life among cancer survivors and their families.","authors":"Jingxuan Zhao,&nbsp;K Robin Yabroff","doi":"10.1186/s13584-023-00572-x","DOIUrl":"https://doi.org/10.1186/s13584-023-00572-x","url":null,"abstract":"<p><p>Cancer is one of the most expensive medical conditions to treat worldwide, affecting national and local spending, as well as household budgets for patients and their families. In this commentary about a recent paper from Tur‑Sinai et al., we discuss the high out-of-pocket spending and medical and non-medical financial hardship faced by cancer patients and their families at the end-of-life in Israel. We provide recent information about the costs of health care in Israel and other high-income countries with (i.e., Canada, Australia, Japan, and Italy) and without universal health insurance coverage (i.e., United States, a country with high healthcare costs and uninsurance rate), and highlight the role of improving health insurance coverage and benefit design in reducing financial hardship among cancer patients and their families. Recognizing that financial hardship at the end of life affects both patients and their families, developing comprehensive programs and policies in Israel as well as in other countries is warranted.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"12 1","pages":"24"},"PeriodicalIF":4.5,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10324154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9802466","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":"Correction: Cytomegalovirus (CMV) seroprevalence among women at childbearing age, maternal and congenital CMV infection: policy implications of a descriptive, retrospective, community-based study.","authors":"Assaf Ben Shoham,&nbsp;Yechiel Schlesinger,&nbsp;Ian Miskin,&nbsp;Ziva Kalderon,&nbsp;Rachel Michaelson-Cohen,&nbsp;Yonit Wiener-Well","doi":"10.1186/s13584-023-00571-y","DOIUrl":"https://doi.org/10.1186/s13584-023-00571-y","url":null,"abstract":"","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"12 1","pages":"23"},"PeriodicalIF":4.5,"publicationDate":"2023-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10210446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9526069","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":"Where internal medical patients receive intensive interventions: results from a tertiary-care hospital in Israel.","authors":"Gideon Leibner,&nbsp;Shuli Brammli-Greenberg,&nbsp;David Katz,&nbsp;Yaakov Esayag,&nbsp;Nechama Kaufman,&nbsp;Adam J Rose","doi":"10.1186/s13584-023-00570-z","DOIUrl":"https://doi.org/10.1186/s13584-023-00570-z","url":null,"abstract":"<p><strong>Background: </strong>Patients admitted to internal medicine may be moved to more advanced-care settings when their condition deteriorates. In these advanced care settings, there may be higher levels of monitoring and greater ability to deliver Intensive Medical Treatments (IMTs). To the best of our knowledge, no previous study has examined the proportion of patients at different levels of care who receive different types of IMTs.</p><p><strong>Methods: </strong>In this retrospective observational cohort study, we examined data from 56,002 internal medicine hospitalizations at Shaare Zedek Medical Center, between 01.01.2016 and 31.12.2019. Patients were divided according to where they received care: general-ward, Intermediate-Care Unit, Intensive Care Unit (ICU), or both (Intermediate-Care and ICU). We examined the rates at which these different groups of patients received one or more of the following IMTs: mechanical ventilation, daytime bi-level positive airway pressure (BiPAP), or vasopressor therapy.</p><p><strong>Results: </strong>Most IMTs were delivered in a general-ward setting - ranging from 45.9% of IMT-treated hospitalizations involving combined mechanical ventilation and vasopressor therapy to as high as 87.4% of IMT-treated hospitalizations involving daytime BiPAP. Compared to ICU patients, Intermediate-Care Unit patients were older (mean age 75.1 vs 69.1, p < 0.001 for this and all other comparisons presented here), had longer hospitalizations (21.3 vs 14.5 days), and were more likely to die in-hospital (22% vs 12%). They were also more likely to receive most of the IMTs compared to ICU patients. For example, 9.7% of Intermediate-Care Unit patients received vasopressors, compared to 5.5% of ICU patients.</p><p><strong>Conclusion: </strong>In this study, most of the patients who received IMTs actually received them in a general-bed and not in a dedicated unit. These results imply that IMTs are predominantly delivered in unmonitored settings, and suggest an opportunity to re-examine where and how IMTs are given. In terms of health policy, these findings suggest a need to further examine the setting and patterns of intensive interventions, as well as a need to increase the number of beds dedicated to delivering intensive interventions.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"12 1","pages":"22"},"PeriodicalIF":4.5,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10206337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9607035","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":"Use and barriers to the use of telehealth services in the Arab population in Israel: a cross sectional survey.","authors":"Nadav Penn,&nbsp;Michal Laron","doi":"10.1186/s13584-023-00569-6","DOIUrl":"https://doi.org/10.1186/s13584-023-00569-6","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Studies conducted in Israel and in other countries show that minority populations typically underuse telehealth services notwithstanding the advantages inherent in the use of these services. The goal of this study was to examine telehealth use patterns and the barriers to the use of telehealth services in the Arab population in Israel, which is a culturally and ethnically varied minority population with a unique language and culture.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A telephone survey was conducted among a representative sample of the adult Arab population in Israel from October 29 to November 4, 2020. Of the randomly sampled 1,192 adult Israeli Arabs 501 participants responded to the entire questionnaire, representing a response rate of 42%.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study found that the majority of the adult Arab population in Israel faced no technology or Internet accessibility barriers. Thus, the majority of adult Israeli Arabs (87%) use the Internet on a daily basis and have smartphones (96%) and an Internet connection (93%). However, although they have high technology and Internet accessibility, their use of telehealth services is mostly a telephone appointment with a doctor (66%). At the same time, significantly lower use rates were found with regard to advanced telehealth services delivered through the Internet, e.g., consultation with a health care provider by email or chat (34%) or video chat (8%) and ordering of medications (14%). It was found that Arab Christians are more likely to use digital services than Arab Muslims, even when background characteristics are statistically controlled. Lack of awareness was found to be the major barrier to the use of telehealth services, specifically advanced services such as ordering of medications (23%) and video medical consultation (15%). A high rate of women cited the unmet need for the discreet provision of telehealth services as a barrier to their use of the services. It was also found that the majority of the adult Arab population had no objection in principle to the use of email or chat (75%) or video chat (51%) for consultation with a health care provider. It was further found that facilitating factors promoting the use of telehealth services include previous acquaintance with the health care provider, a stable internet infrastructure, the provision of the services in the Arabis language, guidance in the use of the service, a recommendation by a health care provider, and the participation of a family member in the online medical consultation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The study findings highlight the need for the provision of accessible and customized telehealth services for minority populations. Whether delivered over the phone or through the Internet, the services have to be culturally (for Muslims and Christians) and linguistically (Arabic) adapted, guidance in the use of the services should be provided, and service marketing should be t","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"12 1","pages":"21"},"PeriodicalIF":4.5,"publicationDate":"2023-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10204005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9610820","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":"A call to readjust the Israeli school feeding program.","authors":"Dorit Nitzan","doi":"10.1186/s13584-023-00568-7","DOIUrl":"10.1186/s13584-023-00568-7","url":null,"abstract":"<p><p>The COVID-19 pandemic challenged the food and nutrition security status of thousands of children in Israel. This commentary argues that policymakers should urgently readjust the Israeli school feeding program based on experts' advice. Children should have the right to select food items, grow the items, prepare the meals, and clean and care for the waste together. They should eat as a community in suitable school dining rooms. Access to the school feeding program should also be ensured during emergencies, school closures, isolation and quarantine, treatment, and rehabilitation of children. The food provided through the program should be integrated into the food baskets of their families, aimed at improving their households' food and nutrition security. It is important to activate a universal school feeding program that does not differentiate, separate, and stigmatize children, their households, their communities, and their schools. The United States National School Lunch Program is briefly reviewed, highlighting the importance of the program's routine monitoring, evaluation, and improvement. Engaging the children in planning the meals and in the production, preparedness, provision, and waste management processes are key to improving their involvement, health literacy and promotion, and their families' resilience. Implementing a holistic Food System Approach, including school gardening and \"Farm to School,\" is suggested. It is recommended to urgently formulate a modern, universal, and comprehensive Israeli Food and Nutrition Security Plan, with a dedicated chapter for the upgraded School Feeding Programe with a section on its implementation in emergency preparedness, response, and Resilience. It should be anchored in the Food Systems framework and the One Health Approach.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"12 1","pages":"20"},"PeriodicalIF":4.5,"publicationDate":"2023-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10171145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9528916","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}