Reorganization of secondary medical care in the Israeli Defense Forces Medical Corps: A cost-effect analysis.

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.

journal_name

Mil Med

journal_title

Military medicine

authors

Yagil Y,Arnon R,Ezra V,Ashkenazi I

doi

10.7205/milmed.171.12.1229

subject

Has Abstract

pub_date

2006-12-01 00:00:00

pages

1229-34

issue

12

eissn

0026-4075

issn

1930-613X

journal_volume

171

pub_type

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