Wilf-Miron R, Rotstein Z, Noy S, Turjeman A, Israeli A
Department of Medical Management, Sheba Medical Center, Tel Hashomer, Israel.
Health Policy. 1999 Nov;49(3):137-47. doi: 10.1016/s0168-8510(99)00053-6.
To explore the attitudes of Israeli physicians towards the feasibility and potential consequences of the newly implemented health care reform.
Physicians' attitudes were examined soon after the enactment of a National Health Insurance Law, the first element of the reform to be implemented.
A nationwide mail survey.
A random sample of 2000 practicing physicians.
Attitudes towards the health care system prior to the reform; predicted effects of the reform on health care and medical practice.
Most of the respondents think that the system requires a change. Quality of community-based care is expected to increase, in contrast to hospital care. The reform is believed to exert an adverse effect on medical practice. Attitude is significantly influenced by practice setting and speciality: community setting and general practice correlate with less desire for a major change. Specialists believe that reform elements which will shift the balance towards the hospitals will have the greatest benefit on the health system. GPs, compared to specialists, are more optimistic regarding quality and accessibility of services (P<0.01).
Our survey suggested that Israeli physicians favor a change in the health care system, despite a perceived adverse effect of the reform on medical practice. Since the reform is believed to shift the balance from the hospitals to the community, respondents support changes that will compensate for the imbalance.
探讨以色列医生对新实施的医疗改革的可行性及潜在后果的态度。
在《国家医疗保险法》颁布后不久，对医生的态度进行了调查，该法是改革实施的首个要素。
全国范围内的邮寄调查。
2000名执业医生的随机样本。
改革前对医疗系统的态度；改革对医疗保健和医疗实践的预期影响。
大多数受访者认为该系统需要变革。与医院护理相比，预计社区护理质量会提高。改革被认为会对医疗实践产生不利影响。态度受执业环境和专业的显著影响：社区环境和全科医学与对重大变革的需求较低相关。专科医生认为，将平衡转向医院的改革要素将对卫生系统产生最大益处。与专科医生相比，全科医生对服务质量和可及性更为乐观（P<0.01）。
我们的调查表明，尽管改革被认为会对医疗实践产生不利影响，但以色列医生仍支持医疗系统的变革。由于改革被认为会将平衡从医院转向社区，受访者支持能够弥补这种不平衡的变革。
