Newly implemented health system reform in Israel: physicians' attitudes.

OBJECTIVE

To explore the attitudes of Israeli physicians towards the feasibility and potential consequences of the newly implemented health care reform.

DESIGN

Physicians' attitudes were examined soon after the enactment of a National Health Insurance Law, the first element of the reform to be implemented.

SETTING

A nationwide mail survey.

SUBJECTS

A random sample of 2000 practicing physicians.

MAIN OUTCOME MEASURES

Attitudes towards the health care system prior to the reform; predicted effects of the reform on health care and medical practice.

RESULTS

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).

CONCLUSIONS

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.