Private medical services in acute‐care hospitals in Israel

Shirom, Arie

doi:10.1002/hpm.642

Cited by 9 publications

(8 citation statements)

References 22 publications

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“…In this study the MCH ‘special clinic’ is the sole example, although similar arrangements are described in the literature in other countries (Shirom 2001; Suwandono et al 2001). These services are officially regulated and use separate resources and accounting systems; patients pay higher prices than in the main public facility.…”

Section: Resultsmentioning

confidence: 93%

Negotiating markets for health: an exploration of physicians’ engagement in dual practice in three African capital cities

Russo

McPake

Fronteira

et al. 2013

Health Policy and Planning

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Scarce evidence exists on the features, determinants and implications of physicians’ dual practice, especially in resource-poor settings. This study considered dual practice patterns in three African cities and the respective markets for physician services, with the objective of understanding the influence of local determinants on the practice. Forty-eight semi-structured qualitative interviews were conducted in the three cities to understand features of the practice and the respective markets. A survey was carried out in a sample of 331 physicians to explore their characteristics and decisions to work in public and private sectors. Descriptive analysis and inferential statistics were employed to explore differences in physicians’ engagement in dual practice across the three locations. Different forms of dual practice were found to exist in the three cities, with public physicians engaging in private practice outside but also inside public facilities, in regulated as well as unregulated ways. Thirty-four per cent of the respondents indicated that they worked in public practice only, and 11% that they engaged exclusively in private practice. The remaining 55% indicated that they engaged in some form of dual practice, 31% ‘outside’ public facilities, 8% ‘inside’ and 16% both ‘outside’ and ‘inside’. Local health system governance and the structure of the markets for physician services were linked to the forms of dual practice found in each location, and to their prevalence. Our analysis suggests that physicians’ decisions to engage in dual practice are influenced by supply and demand factors, but also by how clearly separated public and private markets are. Where it is possible to provide little-regulated services within public infrastructure, less incentive seems to exist to engage in the formal private sector, with equity and efficiency implications for service provision. The study shows the value of analysing health markets to understand physicians’ engagement in professional activities, and contributes to an evidence base for its regulation.

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Section: Resultsmentioning

confidence: 93%

Negotiating markets for health: an exploration of physicians’ engagement in dual practice in three African capital cities

Russo

McPake

Fronteira

et al. 2013

Health Policy and Planning

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“…Two-tier charging is widespread in public health systems in both high and low income settings (National Economic Research Associates (NERA) 1995; Carmel and Halevy, 1999;Nolan and Wiley, 2000;Shirom, 2001;Suwandono et al, 2001). In a number of low and middle income countries in particular, governments are actively pursuing two-tier charging ostensibly as a means to bridge the gap between the funding needs of hospitals, the limited ability to pay of the majority of the population, and the restricted capacities of public funds.…”

Section: Introductionmentioning

confidence: 98%

Two-tier charging strategies in public hospitals: Implications for intra-hospital resource allocation and equity of access to hospital services

McPake¹,

Hanson²,

Adam³

2007

Journal of Health Economics

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“…For example, the provision of private medicine in public hospitals in Israel has been a subject of a major debate [31-33]. According to the physicians interviewed, they think that patients who seek second opinions do so in the private sector.…”

Section: Discussionmentioning

confidence: 99%

Orthopedic surgeons’ and neurologists’ attitudes towards second opinions in the Israeli healthcare system: a qualitative study

Greenfield

Pliskin

Wientroub

et al. 2012

Isr J Health Policy Res

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BackgroundSecond opinion is a treatment ratification tool that may critically influence diagnosis, treatment, and prognosis. Second opinions constitute one of the largest expenditures of the supplementary health insurance programs provided by the Israeli health funds. The scarcity of data on physicians’ attitudes toward second opinion motivated this study to explore those attitudes within the Israeli healthcare system.MethodsWe interviewed 35 orthopedic surgeons and neurologists in Israel and qualitatively analyzed the data using the Grounded Theory approach.ResultsAs a common tool, second opinion reflects the broader context of the Israeli healthcare system, specifically tensions associated with health inequalities. We identified four issues: (1) inequalities between central and peripheral regions of Israel; (2) inequalities between private and public settings; (3) implementation gap between the right to a second opinion and whether it is covered by the National Health Insurance Law; and (4) tension between the authorities of physicians and religious leaders. The physicians mentioned that better mechanisms should be implemented for guiding patients to an appropriate consultant for a second opinion and for making an informed choice between the two opinions.ConclusionsWhile all the physicians agreed on the importance of the second opinion as a tool, they raised concerns about the way it is provided and utilized. To be optimally implemented, second opinion should be institutionalized and regulated. The National Health Insurance Law should strive to provide the mechanisms to access second opinion as stipulated in the Patient’s Rights Law. Further studies are needed to assess the patients' perspectives.

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Private medical services in acute‐care hospitals in Israel

Cited by 9 publications

References 22 publications

Negotiating markets for health: an exploration of physicians’ engagement in dual practice in three African capital cities

Negotiating markets for health: an exploration of physicians’ engagement in dual practice in three African capital cities

Two-tier charging strategies in public hospitals: Implications for intra-hospital resource allocation and equity of access to hospital services

Orthopedic surgeons’ and neurologists’ attitudes towards second opinions in the Israeli healthcare system: a qualitative study

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