Reorganization of Secondary Medical Care in the Israeli Defense Forces Medical Corps - A Cost-Effect Analysis
Authors: Yagil, Yael; Yagil, Yael; Arnon, Ronen; Ezra, Vered; Ashkenazi, Isaac
Source: Military Medicine, Volume 171, Number 12, December 2006 , pp. 1229-1234(6)
Abstract:Objective: To increase accessibility and availability of secondary medical care, 10 secondary unit specialist clinics were established side-by-side with five existing regional specialist centers, thus achieving decentralization. The purpose was to analyze the impact of this reorganization on overall consumption of secondary medical care and expenditures. Methods: Consumption of secondary medical care was analyzed by using computerized clinic and Medical Corps databases. Functional efficiency and budgetary expenditures were evaluated in four representative unit specialist clinics. Results: The reorganization resulted in an 8% increase in total secondary care consumption over 2.5 years. The establishment of unit specialist clinics did not achieve increased accessibility or availability for military personnel. Functional analysis of representative unit specialist clinics showed diversity in efficiency, differences in physicians’ performance, and excess expenditures. Conclusion: The decentralizing reorganization of secondary medical care generated an increase in medical care consumption, possibly because of supply-induced demand. The uniform inefficiency of the unit specialist clinics might have been related to incorrect planning and management. The decentralization of secondary medical care within the Israeli Defense Forces has not proved to be cost-efficient.
Document Type: Research Article
Affiliations: Medical Services and Supply Center, Medical Corps, Israeli Defense Forces, Beer-Sheba, Israel.
Publication date: December 2006
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Military Medicine is the Association's official monthly journal. The objective of the Journal is to promote awareness of Federal medicine by providing a forum for responsible discussion of common ideas and problems relevant to Federal healthcare. Its mission is: To increase healthcare education by providing scientific and other information to its readers; to facilitate communication; and to offer a prestige publication for members' writings.
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