64. Accords or Peace between Israel and the Palestinians

Bin-Nun, Yoel; Ben‐Rafael, Eliezer; Schoeps, Julius H.; Sternberg, Yitzhak; Glöckner, Olaf

doi:10.1515/9783110351637-079

Cited by 4 publications

(10 citation statements)

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“…The constant changes in these determinants in recent decades have created complex ecosystems with changing needs, exacerbated by the added pressure to reduce public expenditure on health [ 2 – 4 ]. This local and global ecosystem creates a dynamic, unstable, and competitive environment that affects the provision and management of health services [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…The HMOs use various payment systems to purchase hospitalization services from the hospitals. The distribution of hospital beds, in terms of ownership, location, and main costs—such as purchase of expensive equipment—is arranged and overseen by the Ministry of Health [ 5 , 7 ]. The public system comprises hospitals with various types of owners—including nonprofit organizations, HMOs, and the Ministry of Health—and competes with a private system [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…The new financial arrangements, capitation arrangements, updating of fees, and competition among the HMOs generated pressure on the hospitals and a decline in the HMOs’ use of their services. This generated an acute need for the hospitals to develop new services and compete with each other [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…Among the creative business solutions has been the establishment of research funds associated with the hospitals. Under a 2002 law, they function as legally separate entities and make possible activity outside regular work hours, research, employment, medical tourism, and other revenue-generating business activity [ 5 , 7 ]. The funds provide administrative autonomy and flexibility in the use of resources and employment.…”

Section: Introductionmentioning

confidence: 99%

“…Many factors—the global ecosystem, the changes in the local ecosystem described above, budgetary constraints, a substantial increase in the use of medical services, new financial arrangements with the HBOs and hospitals, updating of fees, competition by the HMOs, and the development of private supplementary insurance policies—have all combined to undermine the sought-after financial stability and generate a chain reaction of limiting the use of hospital services by the HMOs while creating great competition among the hospitals. This has resulted in continuous financial pressure, great work pressure, and great uncertainty for the hospitals [ 5 ]. Having to function with budgetary shortfalls is driving an increase in the business behavior of hospitals and a blurring of boundaries between being regulated public organizations and organizations acting in an autonomous business manner with the aim of trying to survive or at least achieve financial stability [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Strategic management as adaptation to changes in the ecosystems of public hospitals in Israel

Naamati-Schneider

2020

Isr J Health Policy Res

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Background Health systems worldwide function in constantly changing local and global ecosystems. This is the result of economic, demographic, and technological changes, among others. In recent decades Israel has started implementing reforms in the public health services that have led to far-reaching changes in the health system, and consequently, increased competition within it. The impact of these changes has been exacerbated by pressure to reduce per capita public health costs, coupled with increased demand and greater health awareness. All these changes have created a turbulent environment for healthcare organizations in Israel. To cope with this dynamic environment, various parts of the system have had to adopt appropriate management behaviors and business styles. This study, carried out in six public hospitals in Israel, evaluates the nature and degree of adaptation, implementation, and inculcation of management strategies in public hospitals in Israel, using the Ginter model of strategic management of health organizations. Methods The study used semi-structured in-depth interviews of key figures in the health system and managers at various levels in the hospitals and HMOs included in the sample. The 55 interviews, conducted in two time periods, were analyzed in accordance with an established theory of qualitative methodological analysis. Results The main findings are that the health market and hospitals in Israel are increasingly adopting competitive business behaviors. But strategic managerial behavior has been adopted only in part, and there is a lack of collaboration between staff and management in defining goals and strategic activity. These are obstacles to change and inculcation of the strategy in hospitals. Conclusions This study affords an important view over time and a better understanding of the behavior and adaptation of hospitals in Israel to their constantly changing surroundings. Adapting and inculcating appropriate managerial strategies in hospitals requires close collaboration between staff and management; its absence is an obstacle that contributes to partial, and possibly counter-productive, strategic behavior. The solution may lie in a combination of changes: providing hospital management with the necessary tools and broad professional support by the Ministry of Health; organizational changes in hospital management and departments; the creation of a clinical leadership role; and a self-supervised planning system . Policy recommendations These recommendations regarding training and the direction and organization of the change, coupled with systemic oversight of them by the Ministry of Health, will enable the system to become more efficient. They are particularly relevant today because the Covid-19 pandemic has exacerbated and highlighted Israeli public hospitals’ financial and organizational problems. Hospitals that already faced many challenges have had to cope with an unfamiliar medical crisis and a reduction of elective medical activity, causing them various types of damage, especially in term of economic stability. The hospitals’ fragile situation must become a top government priority because it can no longer be ignored. To achieve a strong healthcare system with stable hospitals, able to respond both to everyday challenges and to crises like the current pandemic, policymakers must provide financial and organizational support alongside managerial training, while maintaining an overall systemic plan.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Strategic management as adaptation to changes in the ecosystems of public hospitals in Israel

Naamati-Schneider

2020

Isr J Health Policy Res

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The PA profession in Israel

Ozer

2022

Jaapa

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Implementation of physician assistants (PAs) in EDs throughout Israel began in May 2016. The profession is now showing some progress but at a relatively slow rate. This article provides an overview of Israel and its healthcare system, and describes the implementation, deployment, education, training, and scope of practice of PAs in Israel, plus recent developments and suggestions for advancing the profession.

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Intraorganization conflicts of interest in hospitals adapting to a changing ecosystem

Naamati-Schneider

2021

JHOM

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PurposeHealth systems function in an ecosystem that is turbulent and competitive because of demographic, economic, political, technological and lifestyle changes and sociopolitical influences, requiring hospitals to adopt comprehensive business strategies. Failure to do so may result in duplication, waste and deficits. This original article uses the prism of agency theory to examine differences in approach at two levels of hospital management and the consequent problems in the incorporation of necessary changes. Agency theory posits an inherent conflict of interest in organizations, including health organizations: the managers (agents) always aim to maximize their profit or personal interest instead of that of the owner or organization (principal), potentially causing difficulty in managing the organization. The aim is to generate recommendations for policymakers.Design/methodology/approachThe study is based on 30 semi-structured, in-depth interviews with key figures in the health system and on two levels of hospital management: senior managers and heads of selected departments. The analysis used a categorical qualitative methodology.FindingsThe main findings are five key themes: views of business behavior, asymmetry of interests, asymmetry of information, transparency and cooperation between various levels of management and ambivalence toward business in hospitals. The two levels of management are clearly divided in terms of interests, information and activity, leading to difficulty in cooperation, efficiency and achievement of organizational goals.Originality/valueUsing agency theory, this study provides a systemic and organizational view of hospitals' management and environmental adaptation. Understanding the processes and increasing cooperation at various managerial levels can help make the system more efficient and ensure its survival in a dynamic market.

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64. Accords or Peace between Israel and the Palestinians

Cited by 4 publications

References 0 publications

Strategic management as adaptation to changes in the ecosystems of public hospitals in Israel

Strategic management as adaptation to changes in the ecosystems of public hospitals in Israel

The PA profession in Israel

Intraorganization conflicts of interest in hospitals adapting to a changing ecosystem

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