Health and health care in Israel: an introduction
Health and health care in Israel: an introduction
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DOI：
10.1016/s0140-6736(17)30636-0
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发表时间：
2017-06-24
期刊：
影响因子：
168.9
通讯作者：
Israeli, Avi
中科院分区：
文献类型：
--
作者：
Clarfield, A. Mark;Manor, Orly;Israeli, Avi
早在1948年独立之前就开始了，在随后的60年里，以色列建立了一个强有力的、相对有效的公共卫生保健系统，从而在整个生命过程中产生了良好的卫生统计数据。由于生活在英国巴勒斯坦托管地（1922-48年）的人们的倡议，今天的许多卫生服务的发展比国家建立早了几十年。通过颁布1994年《国家健康保险法》，向所有居民提供广泛的高质量服务和技术，在服务点基本上是免费的。除了强大的医学学术文化、设备齐全（尽管拥挤）的医院和强大的初级保健基础设施外，该国还制定了一些示范国家项目，如社区质量指标方案、国家一揽子服务的年度更新以及强大的研究和教育系统。面临的挑战包括曾经主要是公共系统的日益私有化，以及各部门资金不足，导致除其他挑战外，急性医院床位相对较少。尽管进行了大量的组织和财政投资，但由于民族血统或宗教、其他社会经济因素，以及尽管国家面积小，资源的地理分布不均，差距仍然存在。卫生部继续参与许多综合医院的所有权和管理，并直接支付某些保健服务（如老年人机构护理）的费用，这些活动分散了卫生部规划和监督整个保健结构的主要任务。虽然保健系统本身与该国两个主要族裔群体（以色列阿拉伯人和以色列犹太人）的关系非常密切，但我们认为，最广泛意义上的保健可能有助于为该国与邻国之间的和平与和解提供一座桥梁。
Starting well before Independence in 1948, and over the ensuing six decades, Israel has built a robust, relatively efficient public system of health care, resulting in good health statistics throughout the life course. Because of the initiative of people living under the British Mandate for Palestine (1922-48), the development of many of today's health services predated the state's establishment by several decades. An extensive array of high-quality services and technologies is available to all residents, largely free at point of service, via the promulgation of the 1994 National Health Insurance Law. In addition to a strong medical academic culture, well equipped (albeit crowded) hospitals, and a robust primary-care infrastructure, the country has also developed some model national projects such as a programme for community quality indicators, an annual update of the national basket of services, and a strong system of research and education. Challenges include increasing privatisation of what was once largely a public system, and the underfunding in various sectors resulting in, among other challenges, relatively few acute hospital beds. Despite substantial organisational and financial investment, disparities persist based on ethnic origin or religion, other socioeconomic factors, and, regardless of the country's small size, a geographic maldistribution of resources. The Ministry of Health continues to be involved in the ownership and administration of many general hospitals and the direct payment for some health services (eg, geriatric institutional care), activities that distract it from its main task of planning for and supervising the whole health structure. Although the health-care system itself is very well integrated in relation to the country's two main ethnic groups (Israeli Arabs and Israeli Jews), we think that health in its widest sense might help provide a bridge to peace and reconciliation between the country and its neighbours.