To examine the patterns and prevalence of complaints about health services among older clients of Health Maintenance Organizations (HMOs), explore demographic correlates, and compare results with the patterns in the younger population. Primary data were collected from the responses of subjects who participated in two national phone surveys, conducted in Israel over a period of 2 years. The final sample included 372 participants aged 65 and older, and 796 younger persons, who believed they had reasons to complain about their HMO. Of the 372 participants with cause to complain, only 23% had actually complained. Subjects who were 75-years-old and above, with below-average income, had 2.5 times higher probability for not complaining than people under 65. No statistically significant differences were found between the older participants and younger participants regarding the reasons for complaints or the procedures for making them. Recommendations are made for the recognition of older persons as a unique group within the health care system and for developing organizational mechanisms for capturing their unheard voices by HMOs.
This study examined the extent to which people with disabilities express their voices and present complaints about the quality of health services, and how their complaints are submitted, compared to nondisabled persons. Data were collected via two national surveys from 243 people with disabilities and 956 nondisabled respondents in Israel who perceived themselves to be aggrieved by their health providers. People with disabilities complained only slightly more often than nondisabled persons, and the majority of complaints were submitted locally and informally by both groups. Since people with disabilities use health services more frequently than nondisabled persons, the fact that a majority of customers with disabilities remains silent causes the health system to lose important information regarding areas for redress or for service recovery. The results have implications for needed actions by health providers and outreach efforts by advocacy groups as well as for further policy and research directions that can improve the quality of health services to people with disabilities.
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