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Health funds better in monitoring treatment of chronic conditions but not among poor, report finds
By JUDY SIEGEL
02/01/2014
The chronic illnesses the health funds are supposed to look for include asthma, cardiovascular diseases, colon and breast cancer, diabetes and hypertension.
 
Generally, the four public health funds are performing more preventive and diagnostic tests and monitoring treatment results of chronic conditions better among the population at all ages, but some fall between the cracks – especially among the poor.

This was one of the conclusions of the 148-page report, The National Program for Quality Indicators for Community Medicine for 2010 to 2012, made public on Wednesday. The report, prepared by a team headed by Prof. Orly Manor of the Hebrew University-Hadassah School of Public Health and Community Medicine, received much input and anonymous data from Clalit Health Services, Maccabi Health Services, Kupat Holim Meuhedet and Kupat Holim Leumit.

It was the third such report to be published since 2004, when the Health Ministry set up the Quality Indicators Program to see how well the health funds were monitoring the health of their members and acting to promote a healthy lifestyle and minimize the prevalence of chronic diseases.

The chronic illnesses the health funds are supposed to look for include asthma, cardiovascular diseases, colon and breast cancer, diabetes and hypertension. They are also required to check body mass index in members of various ages, anemia in babies and blood cholesterol and how many go for flu and pneumococcal pneumonia shots. The findings will help the ministry, health funds, hospitals and other bodies improve their policies and functioning.

In a number of important indicators, especially developing asthma and getting flu shots, the poor who are not charged copayments for drugs and other services were more than twice as likely to develop the respiratory condition and not to get the lifesaving free vaccinations, according to the report.

A total of 68% of women aged 50 to 74 went for mammograms to detect breast cancer in 2012, which is similar to the figure in the previous report; poor women were 4% less likely than better-off women to undergo the examination. Only 60% of the elderly went for flu shots, but that was 3 percentage points higher than in the previous period.

People found to suffer from high cholesterol levels were quite willing to take statin pills to reduce them; of those aged 55 to 74 found to have high levels, 81% took the pills. Women purchase more prescription drugs than men, especially the younger ones among them. Nearly three-quarters of patients who underwent heart catheterization or bypass surgery in 2012 took statins to reduce their “bad cholesterol” levels. As for diabetes, 6.5% of the whole population was diagnosed with it, a rise of 0.3% in 2012 compared to the previous year, and more need to have their glucose levels under control.

Nine out of 10 Israelis of all ages visited their general practitioner at least once a year, while 97% saw their doctors at least once in five years.

The latest indicators report was the first to record whether or not patients smoke; this was recorded in the medical files of nearly 80% of all people – 73% of teens and over 86% of those aged 65 to 74.

While the prevalence of colorectal cancer remained steady among Jewish men, the prevalence rose significantly among non-Jewish (mostly Arab) men who have changed their lifestyles for the worse, and declined among Jewish women. Immigrants from the former Soviet Union are at higher risk for this usually fatal type of cancer compared to the general population.

In 2012, 54% of target groups (aged 50 to 74) underwent some kind of examination for colorectal cancer – either the more accurate and efficient colonoscopy or via stool samples.

Seventy percent of seven-year-olds underwent checks of their height and weight, an increase of 3% compared to that in the previous indicators report.

At the end, the authors noted that just testing early for conditions is not enough; all populations must be treated on time and efficiently. Additional indicators should be added to the program, they said, and more research needs to be conducted.
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