Power Gaps Among Stakeholders in Israel's Primary Care and the Role of Primary Care Physicians' Relative Power in Their Intention to Use Video-Consultations with Patients.

Although some correlates of primary care physicians (PCPs) telemedicine adoption have been studied, little is known about whether the intention to use video-consultations (VCs) relates to how PCPs view their power, relative to other stakeholder groups in primary care. The aim of this study was (1) to describe PCPs', patients', and policy makers' (PMs) views of their power and (2) to explore how PCPs views of power are associated with their intention to use VC. A convergent parallel mixed-methods design was used.

Using the capabilities approach to understand inequality in primary health-care services for people with severe mental illness.

Background: Epidemiological studies show disparities in the provision of physical health-care for people with severe mental illness. This observation includes countries with universal health insurance. However, there is limited in-depth data regarding the barriers preventing equality of physical health-care provision for this population.

Knowledge and attitudes about mental health among older immigrants from the former Soviet Union to Israel and their primary care physicians.

Previous studies have documented a high prevalence of psychological distress and mental illness among older immigrants from the former Soviet Union (FSU) in Israel. Yet, this population rarely seeks help from mental health providers. The present study aimed to identify beliefs and attitudes about depression and anxiety among older immigrants from the FSU treated in primary care, and among their primary care physicians, who were also FSU immigrants.

Video or In-Clinic Consultation? Selection of Attributes as Preparation for a Discrete Choice Experiment Among Key Stakeholders.

Introduction: Video consultations (VCs) provide increased accessibility of primary care to remote areas and overall improved care for chronic patients. They also contribute to higher patient satisfaction and improved resource management. Despite these benefits, VC integration into the health system is complex and slow.

Evaluating an organization-wide disparity reduction program: Understanding what works for whom and why.

Background: Disparity-reduction programs have been shown to vary in the degree to which they achieve their goal; yet the causes of these variations is rarely studied. We investigated a broad-scale program in Israel's largest health plan, aimed at reducing disparities in socially disadvantaged groups using a composite measure of seven health and health care indicators.

Methods: A realistic evaluation was conducted to evaluate the program in 26 clinics and their associated managerial levels.

Direct and indirect health economic impact of hypoglycaemia in a global population of patients with insulin-treated diabetes.

Aims: The Hypoglycaemia Assessment Tool (HAT) study investigated the health economic impact of hypoglycaemic events in 24 countries, including countries without previously published data on hypoglycaemia.

Methods: Self-assessment questionnaires and patient diaries (4-week prospective period) were completed by adults with type 1 (T1D) or type 2 diabetes (T2D) treated with insulin for more than 12 months (N = 27,585).

Results: Direct economic impacts of hypoglycaemia during the 4-week prospective period, included increased blood glucose monitoring (reported by 69.

Impact of hypoglycaemia on patient-reported outcomes from a global, 24-country study of 27,585 people with type 1 and insulin-treated type 2 diabetes.

Aims: Data on the impact of hypoglycaemia on patients' daily lives and diabetes self-management, particularly in developing countries, are lacking. The aim of this study was to assess fear of, and responses to, hypoglycaemia experienced by patients globally.

Materials And Methods: This non-interventional, multicentre, 4-week prospective study using self-assessment questionnaires and patient diaries consisted of 27,585 patients, ≥18years, with type 1 diabetes (n=8022) or type 2 diabetes (n=19,563) treated with insulin for >12months, at 2004 sites in 24 countries worldwide.

Time-Dependent Risk of Cancer After a Diabetes Diagnosis in a Cohort of 2.3 Million Adults.

Using a time-dependent approach, we investigated all-site and site-specific cancer incidence in a large population stratified by diabetes status. The study analyzed a closed cohort comprised of Israelis aged 21-89 years, enrolled in a health fund, and followed from 2002 to 2012. Adjusting for age, ethnicity, and socioeconomic status, we calculated hazard ratios for cancer incidence using Cox regression separately for participants with prevalent and incident diabetes; the latter was further divided by time since diabetes diagnosis.

Poor glycemic control as a reason for referral of diabetes patients to specialists in Israel.

Aims/introduction: Family physicians face the dilemma of when to refer patients with diabetes to specialists. This study examined attitudes of family physicians to referring patients with poor glucose control to diabetes specialists.

Materials And Methods: At continuous medical education courses, family physicians were asked to respond anonymously, as to whether they generally manage the diabetes of their patients, and specifically those with poor glycemic control (HbA1c>9.

How do integrative practices influence patient-centered care?: An exploratory study comparing diabetes and mental health care.

Background: Integration between organizational units to achieve common goals has been of interest to health systems because of the potential to improve patient-centered care. However, the means by which integrative practices actually influence patient-centered care remain unclear. Whereas many studies claim a positive association between implementation of integrative practices and patient-centered care, others raise concerns that integrative practices may not necessarily improve patient-centered care.

Managing Diabetes Mellitus: A Survey of Attitudes and Practices Among Family Physicians.

Due to the increasing prevalence of diabetes and the shortage of endocrinologists, family physicians have an important role in diabetes management. The purpose of this study was to examine the sources of knowledge, attitudes and practices of family physicians regarding the management of type 2 diabetes. Attendees at continuous medical education (CME) programs in Israel were requested to respond anonymously to written questions about their sources of knowledge about diabetes, the methods of diabetes management they advise their patients, their knowledge of diabetes medication treatments, and their attitudes toward people with type 2 diabetes.

The use of focus groups as a basis for planning and implementing culturally appropriate health promotion among people with diabetes in the Arab community.

Objective: The main study objective was to identify perceived barriers to achieving glycemic control among the Arab population in Israel, by both members of the Arab community with type 2 diabetes and by primary care teams working with the Arab community.

Methods: A series of six focus groups using qualitative research methodology were conducted in two phases among people with diabetes and primary care professionals treating them.

Results: The perception of the disease among people with diabetes was one of low severity.

Barriers to the Treatment of Mental Illness in Primary Care Clinics in Israel.

The present study examined physicians' perceived barriers to the management of mental illness in primary care settings in Israel. Seven focus groups that included a total of 52 primary care Israeli physicians were conducted. Open coding analysis was employed, consisting of constant comparisons within and across interviews.

Between modern and traditional values: Informal mental health help-seeking attitudes according to Israeli Arab women, primary care patients and their providers.

Background: Israeli Arab women under-utilize mental health services.

Objectives: The present study evaluated the use of alternative services for dealing with depression and anxiety among Israeli Arab women and primary care providers.

Material: Four focus groups with primary care patients and two focus groups with primary care providers were conducted.

Factors associated with the type of psychotropic medications purchased for common mental disorders in the largest managed care organization in Israel.

Objective: To evaluate patient and physician characteristics associated with the type of psychotropic medications (anti-anxiety, antidepressant, or both) purchased.

Methods: The Clalit Health Care Services is the largest managed care health fund in Israel, a country that employs a universal healthcare system. We randomly sampled 30,000 primary care patients over the age of 22 as of January, 2006.

Psychometric properties of responses by clinicians and older adults to a 6-item Hebrew version of the Hamilton Depression Rating Scale (HAM-D6).

Background: The Hamilton Depression Rating Scale (HAM-D) is commonly used as a screening instrument, as a continuous measure of change in depressive symptoms over time, and as a means to compare the relative efficacy of treatments. Among several abridged versions, the 6-item HAM-D6 is used most widely in large degree because of its good psychometric properties. The current study compares both self-report and clinician-rated versions of the Hebrew version of this scale.

Cardiovascular risk management in patients with coronary heart disease in primary care: variation across countries and practices. An observational study based on quality indicators.

Background: Primary care has an important role in cardiovascular risk management (CVRM) and a minimum size of scale of primary care practices may be needed for efficient delivery of CVRM . We examined CVRM in patients with coronary heart disease (CHD) in primary care and explored the impact of practice size.

Methods: In an observational study in 8 countries we sampled CHD patients in primary care practices and collected data from electronic patient records.

Diabetes, glucose control, glucose lowering medications, and cancer risk: a 10-year population-based historical cohort.

Background: Both diabetes and glucose-lowering medications have been associated with an increased risk of cancer incidence. This study will compare cancer incidence rates in individuals with and without diabetes; and will investigate, in individuals with diabetes, an association between glucose control and cancer incidence; and between the use of specific glucose-lowering medications, as well as no drug exposure, and cancer incidence.

Methods/design: This is a population based historical cohort study of all individuals aged 21 years or older (about 2,300,000) who were insured by Clalit Health Services, the largest health maintenance organization in Israel during a ten-year study period.

Patients' and physicians' characteristics associated with the purchase of benzodiazepines by older primary care patients in Israel.

This study evaluated patients' and physicians' characteristics associated with the purchase of benzodiazepines by older primary care patients in Israel. The analytic sample consists of those 6,421 patients age 65 and older. We used multi-level analysis with whether or not benzodiazepines were purchased at least once between June 2005 and 2007 as an outcome.

Disparities in antidepressant adherence in primary care: report from Israel.

Objectives: To evaluate patient and physician characteristics associated with the purchase of antidepressant medication for at least 6 months.

Study Design And Methods: Clalit Health Services is the largest managed care health fund in Israel, a country that uses a universal healthcare system. We randomly sampled 30,000 primary care patients over the age of 22 years.

Characteristics associated with purchasing antidepressant or antianxiety medications through primary care in Israel.

Objectives: This study analyzed the role of patient and physician characteristics associated with the purchase of antidepressant or antianxiety medications in Israel, a country that has a universal health care system.

Methods: A national sample of 30,000 primary care patients over the age of 22 was randomly drawn from the registry of the largest health care fund in Israel. Data concerning medication purchase between January and December 2006 were extracted.

[The effect of the introduction of pneumococcal vaccination for adults as a quality measure on vaccination rates in Clalit Health Services].

Background: The incidence of invasive pneumococcal infections in industrialized countries is above 50/100,000 annuaty in adults over the age of 65 years. The Israel Ministry of Health recommends 23-valent polysaccharide anti-pneumococcaL vaccination for patients with immune suppression or chronic diseases and citizens above the age of 65 years.

Methods: in 1.

Twelve-year follow-up of a population-based primary care diabetes program in Israel.

Objective: To describe the effects of a long-term intervention including 72% of Israeli diabetes patients, aimed at improving diabetes care in a primary care setting.

Design: A retrospective periodic population-based cross-sectional study.

Setting: Two health maintenance organizations (HMOs) in Israel-intervention and control.

Reducing health disparities: strategy planning and implementation in Israel's largest health care organization.

Objective: To describe an organization-wide disparity reduction strategy and to assess its success in quality improvement and reduction of gaps in health and health care.

Study Setting: Clalit Health Services, Israel's largest non-for-profit insurer and provider serving 3.8 million persons.

[The quality indigators program in Clalit Health Services: the first decade].

The quality indicators program in the community has existed in Clalit Health Services for over a decade. As a part of this program, approximately 70 evidence-based quality indicators have been defined, in 11 different domains. The indicators relate to preventive medicine (immunizations, early detection of diseases, e.