View
220
Download
0
Tags:
Embed Size (px)
Citation preview
Department of Public Health
Maccabi Healthcare ServicesMaccabi Healthcare Services
The Maccabi Institute for The Maccabi Institute for Health Services ResearchHealth Services Research Department of Public HealthDepartment of Public Health
In the In the
School of Public HealthSchool of Public Health
Tel Aviv UniversityTel Aviv University
January 2007January 2007
Department of Public Health
Israel's leading and most advanced Israel's leading and most advanced
healthcare organization aims tohealthcare organization aims to achieveachieve
Total HealthTotal Health for its members, providingfor its members, providing
integrative andintegrative and personally- tailoredpersonally- tailored health health
care to each and every member, and care to each and every member, and
encouragesencourages excellenceexcellence in the quality of in the quality of
medical care, knowledge andmedical care, knowledge and serviceservice..
Maccabi’s VisionMaccabi’s Vision
Department of Public Health
1,700,000 members (24% Market Share)
3,560 physicians (independent contract and salaried)
797 nurses
429 physical therapists
97 social workers
168 dieticians
197 occupational therapists
177 speech therapists
207 psychologists
5 regions with 152 branches and clinics
Income budget (capitation) $1.28 Billion
Total income $1.65 Billion
Maccabi Statistics - 2007Maccabi Statistics - 2007
Department of Public Health
Pharmacy &
Pharmacology
Director General
Real Estate and Logistics Division
Operations and Hospital
Relations Section
Medical Section
Legal Department
Internal AuditorOmbudsma
n
Media Relations & Public Affairs
Marketing
Human Resources Division
Central Services
Information
Technology Division
Quality Promotion
Medical Technology
Assistant to Director General
Insurance
Division
Supplementary Healthcare Services
Finance & Planning Division
Secondary Healthcare Division
Primary Healthcare Division
Maccabi Institute for
Health Services Research
Purchasing Division
North Region
SharonRegion
CenterRegion
Shfela & Jerusalem
Region
Negev Region
Department of Public Health
ObjectiveObjective
The Institute provides
an organizational framework
for encouraging and supporting
health services research
which is aimed at
promoting community health
for Maccabi members
and for the health sector at large
Department of Public Health
Purpose and GoalsPurpose and Goals
Promoting research activities at Maccabi
This is accomplished by: 1.Encouraging research in relevant areas
according to priorities set by the Institute’s Steering Committee and Advisory Board.
2. Developing and expanding research potential via collaborative activities with researchers from academic institutions and/or external research organizations.
3. Providing the necessary means to implement research projects.
Department of Public Health
The Maccabi Institute for The Maccabi Institute for Health Services ResearchHealth Services Research
DirectorSteering
Committee
Institute Director
Dr. Rachelle Kaye
Research Fund
Department of
Public Health
Maccabi Research
Committee
Advisory Board
Department of Research and Evaluation
MedicalSection
Department of Public Health
Director Dr. Rachelle Kaye
Prof Joshua Shemer
Prof Manfred Green
Mentors andAdvisors
Clinical Appointments
EpidemiologyDr. Gabriel HodickDr. Nurit Friedman
Preventive MedMrs. Leora Valinsky
Dr. Shelley Sternberg
Environmental Health
Dr. Shlomo Moshe
― Dr. Ayalla Blau― Dr. Anthony Heymann― Dr. Yossi Lomnicky― Dr. Yoram Sandhaus― Dr. Yoav Yechezkeli― Dr. Yosef Cohen― Dr. Rachel Miron― Dr. Miki Nobel― Dr. Barbara Silverman― Dr. Galit Fusman― Dr. Ehud Kokia― Dr. Yitzchak Katzir― Dr. Meir Raz― Dr. Eduardo Scejter― Dr. Varda Shalev― Prof. Yair Shapiro
The Department of Public HealthThe Department of Public Health
Department of Public Health
Department of Public HealthDepartment of Public Health The goal is to integrate academic activity with
implementation in healthcare facilities.
Department activities focus on: Research, lecturing, mentoring and collaboration with academic institutions.
Members of the Department form a bridge between academia and the community.
Department members are full time employees, they each hold a half time position in the School of Public Health and half time position at a senior post in Maccabi.
16 Clinical appointees are on the staff, each one holds a quarter time position.
16 more Clinical appointments will be added in the future (4 positions).
Department of Public Health
Research InfrastructureResearch Infrastructure
Members
Physicians and other care givers
Integrated administrative Data Base
Facilities (e.g. mega lab)
Knowledge and research capability
Connections with academic intuitions
Department of Public Health
MaccabiMaccabi offers an ideal framework offers an ideal framework for health services researchfor health services research
Defined and stable population.
Integrated health care system dedicated to finding solutions to unknown problems.
Full access to health status and treatment to all members.
System is characterized by mutual dynamic interaction between health care and research.
Department of Public Health
Information SystemInformation SystemMaccabi’s fully computerized health system Maccabi’s fully computerized health system
includes includes ID numbers and demographic information for each member.
Physician visits including diagnoses and treatments.
Medications prescriptions and purchases at Maccabi pharmacies.
Diagnostic procedures and results: laboratory, pathology.
Visits to expert consultation clinics and para- medical centers.
Visits to out patient hospital clinics.
Hospitalization.
Visits and treatment by supportive and para medical services.
Department of Public Health
Integrated Information Integrated Information SystemSystem
Information SourcesInformation Sources
Clin
icExtr
an
et
Internet
Intra
ne
t
Members Members Members Members
Medical Control
Admin Control
Payment Control
Reimburse-ment Control
Doc. Clinic
Doc. Clinic
Pharmacy
Specialist
Consultant
Paramedic
Diagnostic Center
Firewall
Backup Computer
Main Computer
IDC
Mgmt. of Insured People
IDC
Mgmt. of the Fund
IDC
Mgmt. of Service Provider
s
Drug consumpt
ion control
Labs control
Tele radiology
Web Services
CMRERP
Department of Public Health
Office visits
pathology
imaging
Laboratoryresults
medications
treatments
diagnostics
hospitals
ElectronicElectronic HealthHealth
RecordRecord
Department of Public Health
Information : Type and ScopeInformation : Type and Scope
Administrative and medical data bases on over 2 million people collected over a 16 year time span.
Integrated data base includes clinical, financial and demographic data.
Medical data includes information from all physicians and other care givers, clinics, laboratories and etc.
Recently the centralized electronic health record (EHR) program , further improved data by Physicians.
Data Base is easily accessible to researchers.
Department of Public Health
Heymann AD, Tarashansky I, Kokia E, Chodick G. The use of organizational data for the evaluation of mass prevention programs. Prev Med. 2004 Dec;39(6):1143-7.
Heymann AD, Shapiro Y, Chodick G, Shalev V, Kokia E, Kramer E, Shemer J. Reduced hospitalizations and death associated with influenza vaccination among patients with and without diabetes. Diabetes Care. 2004 Nov;27(11):2581-4.
Heymann AD, Hoch I, Valinsky L, Shalev V, Silber H, Kokia E. Mandatory Computer Field for Blood Pressure Measurement Improves Screening. Family Practice 2005; 22(2):168-9.
Heymann A, Hodick G, Halkin H, Shalev V , Kokia E, Shemer J. The implementation of country-wide managed care for diabetes using medical informatics in a large Preferred Provider Organization. Diabetes research and clinical practice. 2006; 71:290-8.
Lerman Y, Chodick G, Tepper S, Livni g, Ashkenazi S. Seroepidemiology of varicella-zoster virus antibodies among health-care workers and day-care-centre workers. Epidemiol Infect. 2004 Dec;132(6):1135-8.
Publications in Professional Publications in Professional JournalsJournals
Department of Public Health
Heymann AD, Chodick G, Reichman B, Kokia E, Laufer J. Influence of school closure on the incidence of viral respiratory diseases among children and on health care utilization. Pediatr Infect Dis J. 2004 Jul;23(7):675-7.
Hoch I, Heymann AD, Kurman I, Valinsky LJ, Chodick G, Shalev V. Countrywide computer alerts to community physicians improve potassium testing in patients receiving diuretics. J Am Med Inform Assoc. 2003 Nov-Dec;10(6):541-6.
Epub 2003 Aug 4.
Huerta M, Chodick G, Balicer RD, Davidovitch N, Grotto I. Reliability of self-reported smoking history and age at initial tobacco use. Prev Med. 2005 Aug;41(2):646-50 .
Kaye R. Long Term Care – The Next Revolution? Accepted for publication in proceedings from The Third International Jerusalem Conference on Health Policy, Dec 2006.
Moshe S. Levin M. occupational aspects of low back pain. Harefua 2005:144;492-496 .
Publications in Professional Publications in Professional JournalsJournals
Department of Public Health
Chodick G, Heymann AD, Wood F, Kokia E. The direct medical cost of diabetes in Israel. Eur J Health Econ. 2005 Feb 3.
Shalev V, Chodick G, Bialik M, Heymann AD. Predictors of mortality in people with diabetes in a population based five years follow-up. Journal of Clinical Epidemiology accepted 3.06.
Shapiro J, Cohen AD, David M, Chodik G, Viner A, Kremer E, Heymann AD The association between Psoriasis, Diabetes Mellitus and Atherosclerosis in Israel.Journal of the American Academy of Dermatology accepted 8.06
Shmuely H, Samra Z, Ashkenazi S, Dinari G, Chodick G, Yahav J. Association of Helicobacter pylori infection with Shigella gastroenteritis in young children. Am J Gastroenterol. 2004 Oct;99(10):2041-5 .
Sikron R, Wilf-Miron R, Israeli A. Adolescent pregnancy in Israel: a methodology for rate estimation and analysis of characteristics and trends. Harefuah. 2003 Feb;142(2):131-6, 158, 157. Review. Hebrew.
Publications in Professional Publications in Professional JournalsJournals
Department of Public Health
Sample Research GrantsSample Research GrantsResearch SubjectFunding OrganizationGrant (NIS)
A study to examine the differences between different primary physician’s specialty on patient’s health and health utilization
The Israel National Institute for Health Policy and Health Services Research
98,000
Implementing Clinical Guidelines in Primary Care Medicine in Israel: Changing Physicians’ Behavior.
The Israel National Institute for Health Policy and Health Services Research
200,000
What are the factors the encourage and obstruct the delivery of preventive care to the elderly in primary care
The Israel National Institute for Health Policy and Health Services Research
100,000
Financial Thinking for Physicians and Healthcare Consumers
The Israel National Institute for Health Policy and Health Services Research
500,000
The Content of Pediatric Practice in the Community and Training for the Task.
The Israel National Institute for Health Policy and Health Services Research
500,000
Complementary Health Insurance in Europe and the West: Dilemmas and Directions
The Israel National Institute for Health Policy and Health Services Research
65,000
Department of Public Health
Teaching ExperienceTeaching Experience
Dr. Ayala Blau, Lecturer, Wolfson School of Nursing, School of Nursing, Tel Hashomer HospitalDr. Anthony Heymann- Lecturer, Tel Aviv University, Faculty of Medicine, Department of Family MedicineLeora Valinsky – Lecturer, School of Nursing and Public Health, Edith Cowan University, Perth, Western Australia, School of Medicine, Univ Of Western AustraliaDr. Gabriel Chodick- Lecturer, Department of Epidemiology, Tel Aviv UniversityDr. Sandhaus-Lecturer, Tel Aviv University, School of Medicine, pediatricsDr. Shlomo Moshe- Lecturer, Tel Aviv University, School of MedicineDr. Joseph Cohen-Lecturer, Technion, School of Medicine, Wolfson Hospital, diabetesDr. Miki Nobel- Lecturer, Tel Aviv University, School of Medicine, surgeryDr. Galit Fussman- Lecturer, Tel Aviv University, School of Medicine, family medicineDr. Ehud Kokia- Lecturer, Ben Gurion University, health administrationDr. Rachelle Kaye- Lecturer, University of Denver, Guest Lecturer, School of Public Health, Hadassah University Hospital, lecturer, Kiryat Ono College, Health Insurance and long term care
Dr. Shelley Sternberg – Lecturer, University of Toronto, Assistant Prof, Department of Medicine, University of ChicagoProf. Yair Shapiro-Prof, Ben Gurion University, Tel Aviv University, faculty of health sciences, Judea & Samria College, department of physiology and pharmacology, School of Public Health.
Department of Public Health
Types of Support and Mentoring Types of Support and Mentoring for Studentsfor Students
Research planning and Methodology.
Data Extraction.
Data Analysis consultation.
Reporting Consultation.
Department of Public Health
Examples of projects supported Examples of projects supported by the by the
Department of Public HealthDepartment of Public Health
BA Students: Degree in Health AdministrationBA Students: Degree in Health Administrationat the Ben-Gurion University and Emek- Jezrael at the Ben-Gurion University and Emek- Jezrael
CollegeCollege Intervention Program by Nurses in Patients to Improve
Mammography.
Performance Measurement to Gauge Improvement of Mammography Screening.
Effectiveness of Group Therapy Sessions on Health and Compliance in Diabetic Patients.
Predictors of Beta blocker Use for Post MI Patients in a Preferred Provider Organization.
Department of Public Health
Department of Public Health
LONG TERM CARE – THE NEXT REVOLUTION?__________________________________________________________
Rachelle Kaye, PhDMaccabi Healthcare Services, Israel
_____________________________________________________________________
The issue of Long Term Care, particularly for the dependent elderly, has been of increasing concern in all of the countries of the Western world, and is even beginning to demand attention in developing countries. One of the obvious reasons for this growing concern is demography. Life expectancy is increasing and is expected to continue increasing, particularly in the elderly population. From 1960 to 2000, the life expectancy of males aged 65 in OECD countries increased by almost 3 years – an increase of 22%, while the life expectancy of women aged 65 increased by almost 5 years – an increase of more than 30%.[1] As a result of increasing life expectancy as well as the trend in decreasing birth rates, the share of older people in the population has increased dramatically and the prediction is that it will continue to increase. In 1960 the OECD average for the share of persons aged 65 and over was 8.7% of the population. In 2000 it had increased to 13.8% and the projection for 2040 is 25.6%. It should be noted that the average share of persons aged 65+ for Western Europe in 2000 was even higher than the OECD average – about 15%. The increase in the share of persons over 80 in the population is no less dramatic. In 1960 it was 1.3%, in 2000 it was 3.1% and the projection for 2040 is almost 8% - similar to the average for the over 65s in 1960.[2]
Accepted for publication in The Proceedings of the Third International Jerusalem Conference on Health Policy.
Department of Public Health
Department of Public Health
Department of Public Health
Department of Public Health
Department of Public Health
Department of Public Health