Stern Z, Altholz J, Sprung C L
Hadassah University Hospital, Hebrew University School of Medicine, Jerusalem, Israel.
New Horiz. 1994 Aug;2(3):381-5.
The Israeli Health Service was established with the intent of providing an equal standard of care to the entire Israeli population. The Health Service has dealt with changes over the years, including the governing of large populations of Judea, Samaria, and Gaza. In 1990, mass immigration brought 500,000 more individuals to Israel, putting an additional burden on medical services. ICUs in Israel began to emerge after the Six Day War in 1967. The government's Ministry of Health has approved a limited amount of ICU beds. Beyond this set amount, hospital directors decide whether to establish additional ICU beds, weighing departmental pressures from within the hospital to create beds against the knowledge that the hospital will not be reimbursed more than the per diem rate of an ordinary hospital bed ($US 265). Hospital directors and administrators, knowing that the average daily cost of an ICU bed is close to $US 800, turn to their supporting organization to finance the uncontrollable deficit, seek aid from the Ministry of Health to make the per diem rates or diagnosis-related group reimbursements more realistic, and/or implement hospital policies aimed at cutting costs and personnel.
以色列医疗服务机构的设立旨在为全体以色列民众提供同等水平的医疗服务。多年来，该医疗服务机构应对了诸多变化，包括对朱迪亚、撒马利亚和加沙大量人口的管理。1990年，大规模移民使以色列人口增加了50万，给医疗服务带来了额外负担。以色列的重症监护病房（ICU）于1967年六日战争后开始出现。政府卫生部批准了有限数量的ICU床位。超出这一设定数量后，医院院长需决定是否增设ICU床位，要权衡医院内部设立床位的部门压力，同时还要考虑到医院获得的报销不会超过普通医院床位每日的费用（265美元）。医院院长和管理人员深知ICU床位的平均每日成本接近800美元，于是向其支持机构寻求资金以弥补无法控制的赤字，向卫生部寻求帮助以使每日费用或按诊断相关分组的报销更合理，和/或实施旨在削减成本和人员的医院政策。
