Unravelling the determinants of medical practice variation in referrals among primary care physicians: insights from a retrospective cohort study in Southern Israel.

Objectives: Reducing medical practice variation (MPV) is a central theme of system improvement because it is associated with poor health outcomes, increased costs and disparities in care. This study aimed to estimate the extent to which each determinant (patient, physician, clinic) explains MPV among primary care physicians and to identify the characteristics of health services with a greater explained variance.

Methods: A retrospective cohort study of primary care physicians practising in non-private clinics of Clalit Health Services in Southern Israel, for longer than a year between 2011 and 2017 and with more than 100 adult patients per practice.

Adapting to change: Clalit's response to the COVID-19 pandemic.

The COVID-19 pandemic is the most significant global health event of the past century. The profound and unexpected changes that it brought about have forced healthcare organizations to make far-reaching adjustments to accommodate the new reality. With the outbreak of the pandemic in Israel and the understanding of its consequences, Clalit Health Services (Clalit), the largest healthcare organization in Israel, rapidly mobilized in order to provide the best response possible from the perspective of both its patients and its employees.

Medical Practice Variation Among Primary Care Physicians: 1 Decade, 14 Health Services, and 3,238,498 Patient-Years.

Purpose: Variation in medical practice is associated with poorer health outcomes, increased costs, disparities in care, and increased burden on the public health system. In the present study, we sought to describe and assess inter- and intra-primary care physician variation, adjusted for patient and clinic characteristics, over a decade of practice and across a broad range of health services.

Methods: We assessed practice patterns of 251 primary care physicians in southern Israel.

Determinants of Medical Practice Variation Among Primary Care Physicians: Protocol for a Three Phase Study.

Background: One of the greatest challenges of modern health systems is the choice and use of resources needed to diagnose and treat patients. Medical practice variation (MPV) is a broad term which entails the differences between health care providers inclusive of both the overuse and underuse. In this paper, we describe a 3-phase research protocol examining MPV in primary care.

The association between a history of gestational diabetes mellitus and future risk for female malignancies.

Objective: To investigate whether patients with a history of gestational diabetes mellitus (GDM) have an increased future risk for female malignancies.

Study Design: A population-based study compared the incidence of long-term female malignancies (ovary, uterine, breast, and uterine cervix) in a cohort of women with and without a diagnosis of GDM. Deliveries occurred between the years 1988-2013, with a mean follow-up duration of 12 years.

Preterm delivery and future maternal risk of female malignancies.

Purpose: To investigate whether an association exists between preterm delivery and a future risk for female malignancies.

Methods: A population-based study compared the incidence of long-term female malignancies in a cohort of women with and without a history of PTD. Deliveries occurred between the years 1988-2013, with a mean follow-up duration of 12 years.

[COMMUNITY, HOSPITAL AND IN-BETWEEN: QUALITY MEASURES FOR THE CONTINUITY OF CARE].

Introduction: The southern district of Clalit Health Services and Soroka University Medical Center are combined in an organizational configuration: the Southern Region. The Region has developed joint programs in order to advance the quality of medical care whilst optimizing the utilization of available resources. An objective continuous method of assessment was needed to evaluate the continuity of care between the community and the hospital.

Military Weapon Injury Among Illegal Immigrants at the Southern Border of Israel: A Single Level I Trauma Center Series.

This article describes the characteristics of injuries of illegal immigrants admitted to a Level I trauma center after being shot at the southern border of Israel. This is a retrospective descriptive study. Some of the variables were compared to a group of soldiers who sustained penetrating injury at the same region where the illegal migrant were injured.

[SOROKA UNIVERSITY MEDICAL CENTER: THE ROAD TO LEADERSHIP IN QUALITY OF MEDICAL CARE, SERVICE AND RESEARCH].

Soroka University Medical Center is a tertiary hospital, and the sole medical center in the Negev, the southern part of Israel. Soroka has invested in quality, service and research. The region has developed joint programs in order to advance the quality of medical care whilst optimizing the utilization of available resources.

Prepregnancy obesity: a risk factor for future development of ovarian and breast cancer.

The aim of this study was to investigate the association between a history of prepregnancy obesity and a woman's future long-term risk for the development of female malignancies. A population-based study compared the incidence of long-term female malignancies in a cohort of consecutive women with and without a diagnosis of prepregnancy obesity. Deliveries occurred between the years 1988 and 2013, with a mean follow-up duration of 11.

Increased Risk for Ophthalmic Complications in Patients with a History of Preterm Delivery.

Objective Spontaneous preterm deliveries (PTDs) have been consistently associated with maternal vascular complications. We aimed to investigate an association between PTD and subsequent maternal ophthalmic morbidity. Study Design In this population-based cohort study, we included all singleton deliveries occurring between 1988 and 2013.

Preeclampsia and Future Risk for Maternal Ophthalmic Complications.

Objective To investigate whether patients with a history of preeclampsia have an increased risk of long-term ophthalmic complications. Study Design A population-based study comparing the incidence of long-term maternal ophthalmic complications in a cohort of women with and without a history of preeclampsia. Results During the study period, a total of 103,183 deliveries met the inclusion criteria; 8.

Fertility treatments and the risk for ophthalmic complications: a cohort study with 25-year follow-up.

Objective: To investigate whether there is an association between a history of fertility treatments and future risk for long-term maternal ophthalmic complications.

Study Design: A population-based study compared the incidence of long-term maternal ophthalmic complications in a cohort of women with and without a prior history of fertility treatments, including in vitro fertilization (IVF) and ovulation induction (OI). Deliveries occurred between the years 1988-2013, with a mean follow-up duration of 12 years.

Pre-eclampsia and Future Female Malignancy.

Objective: To investigate an association between pre-eclampsia and future genital tract and breast malignancies.

Methods: The incidence of genital tract and breast malignancies was compared in a cohort of women with and without a history of pre-eclampsia. Cumulative incidence was assessed using a Kaplan-Meier survival curve.

[The accreditation program in hospitals: Clalit Health Services experience].

Accreditation is a process for assessing the healthcare organization, to determine if it meets a set of requirements designed to improve quality of care. White research regarding the benefits of accreditation is lacking, accreditation has been shown to be associated with promoting quality. Accreditation differs from licensing and quality assurance audits such as ISO.

Perioperative patient safety: correct patient, correct surgery, correct side--a multifaceted, cross-organizational, interventional study.

Background: It is important to ensure a patient-safe environment in the perioperative setting. With this in mind, a "patient-safety first" philosophy was adopted within our operating room service.

Methods: During the first phase of the interventional study (2001-2002), we defined and executed the organizational and educational aspects of the intervention.