Department of Health Policy and Management, Faculty of Health Sciences, Ben-Gurion University of the Negev, David Ben Gurion Blvd 1, P.O.B. 653, Beer-Sheva, Israel.
Department of Physical Therapy, School of Health Professions, Faculty of Medicine, Tel Aviv University, Chaim Levanon Street, P.O.B. 39040, Tel Aviv, Israel.
Isr J Health Policy Res. 2024 Feb 27;13(1):10. doi: 10.1186/s13584-024-00597-w.
According to Israel's National Health Insurance Law (1994), the Ministry of Health is responsible for the provision of health services in the country including physiotherapy services; moreover, the Special Education Law (1988), stipulates that physiotherapy services for children with motor disabilities, as well as other allied health services, are provided by the Ministry of Education in educational settings. Thus, children with motor disabilities are entitled PT services under two different laws by two different ministries.
To describe the physiotherapy services for children with motor disabilities and examine how policymakers view these services, we conducted a qualitative study including in-depth semi-structured interviews with 10 policymakers from the Ministry of Health and the Ministry of Education, and the national directors of physiotherapy services from three of the four health maintenance organizations in Israel.
Study results indicate that there is an array of physiotherapy services and providers. Despite the regulation of these services for children with motor disabilities, uncertainty and lack of knowledge were found about various issues. Therefore, the thematic analysis was structured around four descriptive questions: Where do the children receive physiotherapy? Who is eligible for physiotherapy treatment and who receives treatment? What interventions do children with motor disabilities receive? Who provides therapy for children with motor disabilities?
Policymakers are dubious regarding the provision of these services, questioning whether children with motor disabilities receive physiotherapy services according to their needs. In addition, the abundance of suppliers does not necessarily improve the quality of services provided to children with motor disabilities, which may ultimately harm their developmental potential.
根据以色列的《国家健康保险法》（1994 年），卫生部负责在该国提供医疗服务，包括物理治疗服务；此外，《特殊教育法》（1988 年）规定，为运动残疾儿童提供物理治疗服务以及其他相关医疗服务，由教育部在教育环境中提供。因此，运动残疾儿童有权根据两部不同的法律、两个不同的部门获得物理治疗服务。
为了描述为运动残疾儿童提供的物理治疗服务，并研究政策制定者如何看待这些服务，我们进行了一项定性研究，包括对卫生部和教育部的 10 名政策制定者、以色列三个健康维护组织的国家物理治疗服务主任进行深入的半结构化访谈。
研究结果表明，存在各种物理治疗服务和提供者。尽管对残疾儿童的这些服务进行了监管，但仍发现了各种问题的不确定性和缺乏知识。因此，主题分析围绕四个描述性问题进行构建：儿童在哪里接受物理治疗？谁有资格接受物理治疗治疗，谁接受治疗？运动残疾儿童接受哪些干预措施？谁为运动残疾儿童提供治疗？
政策制定者对这些服务的提供持怀疑态度，质疑运动残疾儿童是否根据需要接受物理治疗服务。此外，供应商的丰富性并不一定能提高为残疾儿童提供的服务质量，这可能最终会损害他们的发展潜力。
