Israel—start-up nation

2019 ◽  
pp. 28-33
Author(s):  
Mark Britnell
Keyword(s):  
Primary Care ◽  
Health System ◽  
Patient Information ◽  
Health Maintenance Organizations ◽  
Healthcare Organization ◽  
Immigrant Workers ◽  
Mutual Aid ◽  
Health Maintenance ◽  
Non Profit ◽  
Start Up

In this chapter, Mark Britnell focuses on Israel’s healthcare system, one of the best-kept secrets in healthcare. He looks at how Israel has achieved a primary care-led health system with four health maintenance organizations (HMOs) providing citizens with both choice and comprehensive cover. Primary and community care spend first exceeded that of secondary and acute care 20 years ago, but it has taken time. Its origins can be traced back to 1911 when an orchard worker had his arm severed and 150 immigrant workers joined together to form a mutual aid healthcare organization called Clalit, a non-governmental, non-profit entity. They knew that to help themselves they had to help each other, and Clalit is now the largest HMO in Israel with 14 hospitals and more than 1,200 primary and specialized clinics. The health system of Israel is not perfect but is highly innovative—not least in its use of patient information—and deserves attention.

Ethics Case Consultation in Primary Care: Contextual Challenges for Clinical Ethicists

2009 ◽  
Vol 18 (4) ◽  
pp. 397-405 ◽  
Author(s):  
ANNE SLOWTHER
Keyword(s):  
Primary Care ◽  
Clinical Ethics ◽  
Western Europe ◽  
Ethics Consultation ◽  
Ethics Committees ◽  
The United States ◽  
Health Maintenance Organizations ◽  
Ethics Committee ◽  
Health Maintenance ◽  
Case Consultation

The development of ethics case consultation over the past 30 years, initially in North America and recently in Western Europe, has primarily taken place in the secondary or tertiary healthcare settings. The predominant model for ethics consultation, in some countries overwhelmingly so, is a hospital-based clinical ethics committee. In the United States, accreditation boards suggest the ethics committee model as a way of meeting the ethics component of the accreditation requirement for payment by Health Maintenance Organizations (HMOs), and in some European countries, there are legislatory requirements or government recommendations for hospitals to have clinical ethics committees. There is no corresponding pressure for primary care services to have ethics committees or ethics consultants to advise clinicians, patients, and families on the difficult ethical decisions that arise in clinical practice.

Systematic Utilization of Data for Analysis of a Pediatric Emergency-Room Experience

PEDIATRICS ◽  
1975 ◽  
Vol 55 (2) ◽  
pp. 266-274
Author(s):  
George A. Lamb ◽  
Howard L. Weinberger ◽  
Herbert Schneiderman ◽  
Bruce Goldstein
Keyword(s):  
Primary Care ◽  
Emergency Room ◽  
Systematic Approach ◽  
Care Setting ◽  
Health Maintenance Organizations ◽  
Pediatric Emergency ◽  
Health Centers ◽  
Health Maintenance ◽  
Cost Of Health Care ◽  
Neighborhood Health Centers

This report describes the systematic use of emergency-room data to (1) define the experiences of a group of pediatric interns in their emergency-room rotation (especially as they relate to their role as future pediatric practitioners), (2) evaluate, supervise, and learn from their performance in this primary care setting, and (3) provide an ongoing weekly list of illnesses diagnosed in the emergency room as an epidemiological sentinel for the larger community. The future applications of this type of systematic approach, perhaps with computer technology, offer the opportunity for comparison of delivery, quality, and cost of health care between various sources of primary care (emergency-room facilities, private physicians' offices, neighborhood health centers, and health maintenance organizations).

Primary Care of Long-Stay Nursing Home Residents: Approaches of Three Health Maintenance Organizations

1999 ◽  
Vol 47 (2) ◽  
pp. 131-138 ◽  
Author(s):  
David B. Reuben ◽  
John F. Schnelle ◽  
Joan L. Buchanan ◽  
Raynard S. Kington ◽  
Gail L. Zellman ◽  
...  
Keyword(s):  
Primary Care ◽  
Nursing Home ◽  
Nursing Home Residents ◽  
Health Maintenance Organizations ◽  
Health Maintenance

Organization and financing of British primary care groups and trusts: observations through the prism of US managed care

2002 ◽  
Vol 7 (1) ◽  
pp. 43-50 ◽  
Author(s):  
Jonathan Weiner ◽  
Steve Gillam ◽  
Richard Lewis
Keyword(s):  
Primary Care ◽  
Managed Care ◽  
Health Maintenance Organizations ◽  
Health Maintenance ◽  
American Experience ◽  
Care Groups ◽  
Integrated Delivery Systems ◽  
The Usa ◽  
Integrated Delivery ◽  
Managed Care Organizations

There are many parallels between the UK's new primary care commissioning organizations and the managed care organizations and integrated delivery systems that have evolved in the USA over the last three decades. Those building primary care groups and trusts (PCG/Ts) can learn from the American experience with health maintenance organizations and other similar entities. These lessons should also be relevant to those in other countries interested in establishing innovative primary care led organizations within the broader structure of a socialized health care system. Following an overview of US managed care and an update of the progress of the UK's PCG/Ts, we go on to suggest how new consortia of PCG/Ts might be developed and how budgets and provider incentives could be structured. This international comparison suggests that the resources needed to support the development of effective PCG/Ts will be considerable, as will the need to maintain organizational flexibility. If primary care organizations are to thrive, it will be essential to develop truly integrated budgets for primary and secondary care.

The Challenge Is There

PEDIATRICS ◽  
1975 ◽  
Vol 55 (4) ◽  
pp. 568-568
Author(s):  
Morris A. Wessel
Keyword(s):  
Primary Care ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Health Maintenance Organizations ◽  
Primary Role ◽  
Health Maintenance ◽  
Pediatric Nurse ◽  
Primary Care Pediatrician ◽  
Pediatric Nurse Practitioner ◽  
Pediatric Nurse Practitioners

The discussions of Patricia McAfee, Henry Silver, and Abraham Bergman in the November issue suggest that some individuals believe that clinical pediatrics as a practitioner's primary role is about to disappear and be replaced by subspecialty colleagues serving hospitalized patients and pediatric nurse practitioners caring for most of the children currently being seen by doctors in private offices, university clinics, and health maintenance organizations. The primary care pediatrician working with or without a pediatric nurse practitioner has many advantages when compared to his counterpart a few decades ago.

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