Health Ministry: Quality of healthcare in Israel continues to improve

"Compared to parallel programs in the United States and OECD countries, the quality of medicine in Israel is gaining considerable achievements and praise."

Segev Harel becomes the first person to receive the IIBR's new coronavirus vaccine as human trials get underway, Sheba Medical Center, November 1, 2020 (photo credit: MINISTRY OF DEFENSE SPOKESPERSON'S OFFICE)
Segev Harel becomes the first person to receive the IIBR's new coronavirus vaccine as human trials get underway, Sheba Medical Center, November 1, 2020
The eighth annual report of the Health Ministry's Israel National Program for Quality Indicators has found that there has been consistent improvement in the quality of many aspects of the healthcare services provided across Israel.
The program works to measure and improve the quality of care in hospitals, geriatric hospitals, mental health services, Tipot Halav clinics and emergency medical services, such as Magen David Adom and ambulance companies.
By law, healthcare providers must provide the Health Ministry with administrative, financial or medical information to measure the quality of medical care and health services.
The program publishes quality indices concerning treatment of cardiovascular issues, strokes, hip fractures, dialysis adequacy, surgical site infections, emergency medicine wards, pain assessment, infant care, continuing care and the involvement of the patient's family, patient safety, screening among hospitalized patients and geriatric care.
When an index does not improve, the program examines why and works to help medical institutions improve.
The program also grades hospitals around the country based on these indices.
The top three hospitals in Israel were Rabin Medical Center-Beilinson Campus (among very large hospitals), Carmel Medical Center (among large hospitals) and Hasharon (Golda) Medical Center (among small hospitals).
Among geriatric hospitals, Beit Rivka Geriatric Center was the best large hospital and Bayit Balev Nesher was the best small hospital.
"The professionalism and quality of care are especially prominent in the health system's response to the coronavirus," said Health Minister Yuli Edelstein. "Compared to parallel programs in the United States and OECD countries, the quality of medicine in Israel is gaining considerable achievements and praise."
"The measurement is comparative between the various institutions, a source of positive and constructive competitiveness, [and] an incentive for excellence and achievement," said Health Ministry Director-General Hezi Levy. "The program does not intend to encourage uncontrolled competition and the creation of 'over-the-counter' conditions that could harm patients."
Concerning cardiovascular issues, improvements were found in indices measuring the delivery process of EKG results, the statins for acute coronary heart syndrome,  and the administration of aspirin. The cardiac catheterization index has also improved, but issues remain with catheterization among the elderly population.
A significant improvement in assessments for strokes was also recorded since 2016, with the index rising from 82% in 2016 to 97% in 2019.
The index for giving advance notice to hospitals in stroke incidents by ambulance staff remains high and has not changed much in the past three years, according to the report.
The time it takes for patients to receive a CT or MRI scan to identify the type of stroke has decreased from 55 minutes on average in 2015 to 28 minutes in 2019.
The index for carotid artery duplex scans, which can check for blockages in arteries, has significantly improved from 58% in 2015 to 84% in 2019.
The index for geriatric stroke care has also significantly improved from 75% in 2015 to 95% in 2019.
Concerning hip fractures, the report found that the introduction of the index has led to a change in conduct by hospitals and a significant improvement in the rate of surgery performed within 48 hours, which has been found to reduce the risk of infection at the surgery site and reduce mortality rates in the year following surgery. The rate has improved from 71% in 2013 to 86% in 2019.
The functional level of patients with hip fractures has also improved from 68% in 2014 to 95% in 2019.
The index for dialysis adequacy stands at 70% or higher for most service providers across the country.
A steady increase in all three indices concerning antibiotic treatment to prevent infections after surgery has been recorded over the past few years.
The program reported that, across the country, triage at emergency medicine wards stands at nine minutes and sits within optimal time frame.
A gradual improvement has been recorded concerning pain assessment in hospitals, geriatric care and rehabilitative care.
Treatment for infants has seen some improvement as well, according to the report, with a slight improvement recorded concerning visits to Tipot Halav clinics within the first two weeks after birth. This is still below the Health Ministry's goal of 75%.
Vaccination rates for infants has greatly improved over recent years with administration of the measles, mumps, and rubella virus (MMR) vaccine rising to 73% for toddlers up to 13 months of age.
The four-dose vaccination index for 18-month old toddlers stood at 80%, while the three-dose vaccination index for 7-month old infants stood at 64% in 2019.
Developmental testing for young children remained stable in 2019, with the index standing at 84%.
Compliance in the monitoring of the body temperature of premature infants has also improved significantly, rising from 55% in 2017 to 86% in 2019.
The surveying rates of women concerning violence after childbirth has improved with 86% of women being surveyed compared to 53% in 2016. Surveying of women for postpartum depression also improved rising to 82% in 2019.
Concerning the involvement of relatives in patients' healthcare, the rate of parents or guardians who meet with their children's psychiatrists after a psychiatric hospitalization rose from just 27% in 2016 to 86% in 2019.
Concerning continuing treatment, the writing of detailed treatment summaries for mental healthcare, which allow other doctors to continue treatment, has improved with the rate of summaries written within two weeks of hospitalization rising from 51% in 2014 to 88% in 2019.
Significant improvement has also been recorded in the rate of patients discharged from the hospital who schedule an appointment for further treatment with community doctors before even leaving the hospital, rising from 21% in 2014 to 89% in 2019.
The risk assessment index for violence of psychiatric emergency room applicants has improved greatly in recent years, rising from 39% in 2014 to 95% in 2019.
The index for assessments of elderly patients' risk of falling is also high, standing at 98% in 2019.
Indices concerning screening tests for diabetes once every six months, body mass tests (BMI) once every six months, lipid profile tests once every six months, blood pressure measurements once every six months, stool blood tests once a year and mammograms once every two years have all improved for mental health patients.
Indices for geriatric care, including conversations concerning treatment alternatives and preliminary medical guidelines, the detection of foot issues related to diabetes and the monitoring of seniors' diets have improved, while the index for detecting clinical depression in hospitalized seniors has fallen by about 8% in the current measurement year.