Geriatric services in Israel

1
Geriatric services in Israel

• E. Kagan, MD, Soroka Hospital, Ben-Gurion
  University of the Negev
• June 26, 2008

2
Israel Demography

• Population 6,600,000
• 6510, 2003
• 6512, 2005

3
Israel Health Care System

• acute/rehab Canada
• LTC US

(ref Clarfield et al, JAGS 2000, 48980-4)
4
Israel Health Care System (Acute/Rehab)

• publicly administered
• publicly financed (taxes)
• services provided by 4 not -for -profit Sick
  Funds, HMO (health maintenance organization)
• explicit basket of services defined in law
• free at point of service

5
National Health Insurance Law 1995

• as above
• within 3 years, institutional LTC was to be
  included in basket of services, but ..

6
Israel Health Care System (LTC)

• home care
• institutional care

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Home Care

• acute-med (Sick funds/HMOs)
• long term homemaker (10-16 hours of homemaker
  per week) (NII)
• publicly funded(NII)
• means tested but nearly universal (NII)
• Extra services for Holocaust survivors

(ref Brodsky, JAMDA 20012264-8)

• HMO (health maintenance organization)
• NII national Insurance Institute

8
Institutional (25,000 beds)

• to be transferred to HMOs, according to NHIL,
  1995
• MoH - Ministry of health
• HMO (health maintenance organization)
• MoL ( Ministry of Labour/social affairs)

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Health problems of old patients
At home
Hospitals
Intermediate
GP
ED
Long term care units
Different consultations
Geriatric department
geriatric consultations
Nursing homes for skilled nursing patients
others
home care
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Geriatric problems
Geriatric consultations
In polyclinic
Geriatric assessment clinic
Home care unit
Memory clinic
Rehabilitation departments/centers
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LAHAV program
Nurse in polyclinic
Checks information in computer (about ED,
hospitalizations, polypharmacy ets.
3 groups
Dont need in geriatrician
Obligate need in geriatrician
Dont obligate need in geriatrician (according
to decision of GP)
A. Mark Clarfield, MD, FRCPC, Head of Geriatrics,
Soroka Hospital, Sidonie Hecht Professor of
Geriatrics, Faculty of Health Sciences,
Ben-Gurion University, Professor (adjunct),
McGill University, Montreal,Canada. Dr. Press
Yan, Director of Geriatric assessment unit, Beer
Sheva Dr Tzvi Dwolatzky ,Director Department of
Geriatrics and Memory Clinic, Mental Health Center
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The LAHAV comprehensive program for geriatric
services
Inpatient services
Community services
Primary care clinic
Screening program
Acute geriatric and rehabilitation unit
Home care unit
Geriatric assessment unit
Pathways
Geriatric Consultation
Prevention
Intervention
Green
Orange
Dr. Press Yan, Director of Geriatric assessment
unit Dr Tzvi Dwolatzky ,Director Department of
Geriatrics and Memory Clinic, Mental Health Center
Red
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• Teaching programme ( in the south of the Israel)

In Soroka Medical Centre
Out of the hospital
Geriatric residents
Geriatric Consultations - Letter with
explanations - Explanations during consultations
Medical students
Lectures during/after residency
GPs (1 month during their residency)
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Thank you
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