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Patient pathways. https://eurohealthobservatory.who.int/monitors/health-systems-monitor/countries-hspm/hspm/israel-2015/provision-of-services/patient-pathways", "country_ids": [ "ISR" ], "coverage_domains": [ "authoritative_review", "patient_flows", "primary_care", "referral_design", "utilization" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "reported", "excerpt": "patients will usually begin by contacting their family physician", "institution": null, "locator": { "description": "HSPM 5.2 Patient pathways; Brookdale 2021-2022 survey, Key Findings." }, "material_id": "material:424532a7cd1c6596b6edcc87", "notes": [], "origin": "candidate-analytical-mappings", "period": "2024 pathway page; 2021-2022 survey data", "publication_date": null, "publication_year": null, "record_kind": "candidate_analytical_mapping", "record_kind_label": "Candidate Analytical Mapping", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "review_literature" ], "source_system": null, "source_version": { "detected_media_type": "text/html", "response_sha256": "3876612f305855c20f1ce4f6d44ed0fa2af0b529e4f4c25347efb8697226861c" }, "statement": "The pathway source reports that patients usually begin with a family physician, while a 2021-2022 survey found that 60% reported family-doctor coordination. Neither source measures referral completion.", "tags": [], "territory": "Israel", "title": "Reported family-physician pathway", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://eurohealthobservatory.who.int/monitors/health-systems-monitor/countries-hspm/hspm/israel-2015/provision-of-services/patient-pathways" }, { "kind": "source_reference", "source": "Israel health system information", "url": "https://eurohealthobservatory.who.int/countries/israel" }, { "kind": "source_reference", "source": "Population Survey on the Level of Service and Health Care System Performance in 2021-2022", "url": "https://brookdale.jdc.org.il/en/publication/population-survey-on-the-level-of-service-and-health-care-system-performance-in-2021-2022/" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "European Observatory on Health Systems and Policies. Decentralization and centralization, Israel Health Systems and Policy Monitor. https://eurohealthobservatory.who.int/monitors/health-systems-monitor/countries-hspm/hspm/israel-2015/organization-and-governance/decentralization-and-centralization", "country_ids": [ "ISR" ], "coverage_domains": [ "actors", "authoritative_review", "autonomy", "decision_rights", "governance", "government_responsibilities", "reform_history" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "reported", "excerpt": "Israel has a unitary, as opposed to a federal, system", "institution": "European Observatory on Health Systems and Policies", "locator": { "locator_type": "html_text_anchor", "source_word_anchor": "Israel has a unitary, as opposed to a federal, system of government", "source_word_count": 12 }, "material_id": "material:5c260a175d0e04236a931d03", "notes": [ "Do not infer full central control of providers from the unitary-state description." ], "origin": "country-evidence-improvement-sources", "period": "Current HSPM page retrieved August 2026; section maintains the 2015 profile context", "publication_date": null, "publication_year": 2026, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "review_literature" ], "source_system": null, "source_version": { "detected_media_type": "text/html", "response_sha256": "d72448549a85274c7a7c16dfec0bd8cb6f021f4d492a9940c72d1c5ad3ef65c6" }, "statement": "The HSPM page describes Israel as a unitary rather than federal system and says regional administrative divisions lack independent authority comparable to states or länder. This does not allocate each provider operational decision.", "tags": [], "territory": "Israel; national government and administrative regions", "title": "Decentralization and centralization", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://eurohealthobservatory.who.int/monitors/health-systems-monitor/countries-hspm/hspm/israel-2015/organization-and-governance/decentralization-and-centralization" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Ministry of Health, Israel. Health Care during emergency states. https://ironswords.health.gov.il/en/health-services/", "country_ids": [ "ISR" ], "coverage_domains": [ "actors", "authoritative_review", "facility_data", "government_responsibilities", "hospital_organization", "market_structure", "networks", "ownership", "primary_care", "referral_design", "reform_history" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "formal", "excerpt": "For non-life-threatening situations, start with your HMO", "institution": "Ministry of Health, Israel", "locator": { "locator_type": "html_text_anchor", "source_word_anchor": "For non-life-threatening situations, start with your HMO", "source_word_count": 7 }, "material_id": "material:d5cad52e8dc5c5d1bfded4a6", "notes": [ "Keep the emergency-state scope visible; do not infer routine referral completion or provider autonomy." ], "origin": "country-evidence-improvement-sources", "period": "Current Ministry guidance retrieved August 2026; emergency-state scope only", "publication_date": null, "publication_year": 2026, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "official" ], "source_system": null, "source_version": { "detected_media_type": "text/html", "response_sha256": "6bbe821225996e9cf0e9bd33af3a09be2813356ab3e047998a77828205cb3700" }, "statement": "The Ministry's emergency guidance directs people with non-life-threatening needs to start with their health maintenance organization and distinguishes community services from hospital use. It is emergency guidance, not an observed service-use dataset or a routine referral rule.", "tags": [], "territory": "Israel; emergency-state public guidance", "title": "Health Care during emergency states", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://ironswords.health.gov.il/en/health-services/" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "European Observatory on Health Systems and Policies and WHO Regional Office for Europe. Health systems in action 2024: Israel. 2024. https://eurohealthobservatory.who.int/publications/i/health-systems-in-action-israel-2024", "country_ids": [ "ISR" ], "coverage_domains": [ "actors", "authoritative_review", "decision_rights", "governance", "government_responsibilities", "hospital_organization", "market_structure", "networks", "ownership", "primary_care", "referral_design", "reform_history" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "reported", "excerpt": "four competing non-profit health plans responsible for service provision and payment", "institution": "European Observatory on Health Systems and Policies and WHO Regional Office for Europe", "locator": { "locator_type": "html_text_anchor", "source_word_anchor": "four competing non-profit health plans responsible for service provision and payment", "source_word_count": 10 }, "material_id": "material:7eb55d68f306269bac4a6c17", "notes": [ "Keep this reported 2024 synthesis distinct from formal legal authority and provider-level observation." ], "origin": "country-evidence-improvement-sources", "period": "2024 publication; describes system arrangements available to the publication", "publication_date": null, "publication_year": 2024, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "review_literature" ], "source_system": null, "source_version": { "detected_media_type": "text/html", "response_sha256": "fb1bda717047c146018df9beab315ccbac5af676d00e13fb6f6bf78bc22224fa" }, "statement": "The 2024 Observatory synthesis reports a national insurance system, four non-profit health plans responsible for provision and payment, and a major direct provider role for the Ministry of Health. It is a national synthesis, not a provider-level autonomy inventory.", "tags": [], "territory": "Israel national synthesis", "title": "Health systems in action 2024: Israel", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://eurohealthobservatory.who.int/publications/i/health-systems-in-action-israel-2024" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "European Observatory on Health Systems and Policies. Israel health system information. https://eurohealthobservatory.who.int/countries/israel", "country_ids": [ "ISR" ], "coverage_domains": [ "actors", "authoritative_review", "governance", "government_responsibilities", "hospital_organization", "market_structure", "networks", "ownership", "primary_care", "referral_design" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "reported", "excerpt": "Primary care doctors play a gatekeeping role", "institution": "European Observatory on Health Systems and Policies", "locator": { "locator_type": "html_text_anchor", "source_word_anchor": "Primary care doctors play a gatekeeping role for access to secondary care", "source_word_count": 11 }, "material_id": "material:b292ffa66bf16139931e1643", "notes": [ "Do not convert a country overview into a current provider inventory or an observed adherence estimate." ], "origin": "country-evidence-improvement-sources", "period": "Current Observatory country page retrieved August 2026; underlying descriptions have their stated source dates", "publication_date": null, "publication_year": 2026, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "review_literature" ], "source_system": null, "source_version": { "detected_media_type": "text/html", "response_sha256": "2a96cbafab4ea73181e50d3d69abbcbd7a371d18c7cef8aa485ee4d48e2d44ff" }, "statement": "The Observatory country overview reports Ministry of Health direct provision and a four-health-plan system. It also describes primary care gatekeeping while noting community specialist access; this does not establish universal referral compliance.", "tags": [], "territory": "Israel national country overview", "title": "Israel health system information", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://eurohealthobservatory.who.int/countries/israel" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Rosen B, Waitzberg R, Merkur S. Israel: health system review. Health Systems in Transition. 2015;17(6):1-212. https://iris.who.int/server/api/core/bitstreams/29d0cc4b-e3b6-4079-8dd7-ec6bc6cdf4b0/content", "country_ids": [ "ISR" ], "coverage_domains": [ "actors", "authoritative_review", "autonomy", "decision_rights", "facility_data", "governance", "government_responsibilities", "hospital_organization", "market_structure", "networks", "ownership", "patient_flows", "primary_care", "referral_design", "reform_history", "utilization" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "reported", "excerpt": "Israel: health system review", "institution": "European Observatory on Health Systems and Policies", "locator": { "locator_type": "pdf_page_anchor", "source_word_anchor": "organization and governance provision of services", "source_word_count": 6 }, "material_id": "material:d6b5d2526c32a0e5d0104470", "notes": [ "Treat historical ownership, capacity and pathway material as dated context." ], "origin": "country-evidence-improvement-sources", "period": "2015 review; historical contextual evidence", "publication_date": null, "publication_year": 2015, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "review_literature" ], "source_system": null, "source_version": { "detected_media_type": "application/pdf", "file_sha256": "219810cc93703ca84368c7b03f3c8388d73e1835af0fa0e702e227cf9bc0a02c", "page_count": 230, "response_sha256": "219810cc93703ca84368c7b03f3c8388d73e1835af0fa0e702e227cf9bc0a02c" }, "statement": "The 2015 review describes organization, provision and reforms in Israel. Its dated descriptions and counts are retained as historical context and are not used as current estimates without a current source.", "tags": [], "territory": "Israel national review; arrangements and data periods vary by chapter", "title": "Israel: health system review 2015", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://iris.who.int/server/api/core/bitstreams/29d0cc4b-e3b6-4079-8dd7-ec6bc6cdf4b0/content" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Leibner G, Brammli-Greenberg S. Optimizing patient autonomy: a discrete choice experiment on preferences and disparities in healthcare provider selection. Implementation Science Communications. 2025;6:26. https://doi.org/10.1186/s12961-025-01296-x", "country_ids": [ "ISR" ], "coverage_domains": [ "authoritative_review", "decision_rights", "market_structure", "referral_design", "reform_history" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "reported", "excerpt": "for each referral to a service outside the HP", "institution": "Implementation Science Communications", "locator": { "locator_type": "pdf_page_anchor", "source_word_anchor": "for each referral to a service outside the HP", "source_word_count": 9 }, "material_id": "material:0d5f80116193d0e17af0b778", "notes": [ "Do not treat the study’s account of a reform as evidence of its implementation or effects." ], "origin": "country-evidence-improvement-sources", "period": "2025 article; recounts a provider-choice reform implemented in September 2023", "publication_date": null, "publication_year": 2025, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "research_literature" ], "source_system": null, "source_version": { "detected_media_type": "application/pdf", "file_sha256": "2cd38bb96e31c7e164adc497265c9b25a60e482c82e6448e7d9750c4e955f200", "page_count": 9, "response_sha256": "2cd38bb96e31c7e164adc497265c9b25a60e482c82e6448e7d9750c4e955f200" }, "statement": "The study recounts a September 2023 selective-contracting reform for referrals outside a health plan. Its discrete-choice experiment does not measure implementation or population-wide referral behaviour.", "tags": [], "territory": "Israel; health-plan referrals to providers outside a health plan", "title": "Optimizing patient autonomy: a discrete choice experiment on preferences and disparities in healthcare provider selection", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://europepmc.org/articles/PMC11866801?pdf=render" }, { "kind": "embedded_source_url", "source": "URL supplied in citation", "url": "https://doi.org/10.1186/s12961-025-01296-x" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "European Observatory on Health Systems and Policies. Patient pathways, Israel Health Systems and Policy Monitor. https://eurohealthobservatory.who.int/monitors/health-systems-monitor/countries-hspm/hspm/israel-2015/provision-of-services/patient-pathways", "country_ids": [ "ISR" ], "coverage_domains": [ "authoritative_review", "networks", "observed_referral", "patient_flows", "primary_care", "referral_design", "utilization" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "reported", "excerpt": "patients can go directly to a community-based orthopaedic specialist", "institution": "European Observatory on Health Systems and Policies", "locator": { "locator_type": "html_text_anchor", "source_word_anchor": "Alternatively, the patient can go directly to a community-based orthopaedic specialist without referral", "source_word_count": 12 }, "material_id": "material:7d9388786006a541bf08a9c3", "notes": [ "Keep the illustrative pathway separate from observed referral behaviour." ], "origin": "country-evidence-improvement-sources", "period": "Page updated April 2024; pathway is illustrative, not a representative flow measurement", "publication_date": null, "publication_year": 2024, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "review_literature" ], "source_system": null, "source_version": { "detected_media_type": "text/html", "response_sha256": "3876612f305855c20f1ce4f6d44ed0fa2af0b529e4f4c25347efb8697226861c" }, "statement": "The pathway page reports that patients usually contact a family physician, but can directly access a community orthopaedic specialist. It documents reported pathway design and options, not observed population-wide referral completion.", "tags": [], "territory": "Israel; illustrative hip-replacement pathway and cited service context", "title": "Patient pathways", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://eurohealthobservatory.who.int/monitors/health-systems-monitor/countries-hspm/hspm/israel-2015/provision-of-services/patient-pathways" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Laron M, Maoz Breuer R, Fialco S. Population Survey on the Level of Service and Health Care System Performance in 2021-2022. S-215-22. Myers-JDC-Brookdale Institute; 2022. https://brookdale.jdc.org.il/en/publication/population-survey-on-the-level-of-service-and-health-care-system-performance-in-2021-2022/", "country_ids": [ "ISR" ], "coverage_domains": [ "authoritative_review", "observed_referral", "patient_flows", "primary_care", "referral_design", "utilization" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "observed", "excerpt": "60% reported that their family doctor coordinated the care services", "institution": "Myers-JDC-Brookdale Institute", "locator": { "locator_type": "html_text_anchor", "source_word_anchor": "60% reported that the family doctor coordinated the care services they needed", "source_word_count": 12 }, "material_id": "material:3e25288c7e5a52dab2b54e8d", "notes": [ "Keep this self-reported coordination measure distinct from observed referral completion." ], "origin": "country-evidence-improvement-sources", "period": "Data collected October 2021 to March 2022", "publication_date": null, "publication_year": 2022, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "grey_literature" ], "source_system": null, "source_version": { "detected_media_type": "text/plain", "response_sha256": "6da5e8ec07c23945a1c17fd59dc5023117bef10aa6f70e9d8468321784c6f6eb" }, "statement": "In a weighted adult telephone survey, 60% reported that their family doctor coordinated needed care. This patient report does not document a referral pathway or referral-completion rate.", "tags": [], "territory": "Israel; weighted adult population telephone survey", "title": "Population Survey on the Level of Service and Health Care System Performance in 2021-2022", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://brookdale.jdc.org.il/en/publication/population-survey-on-the-level-of-service-and-health-care-system-performance-in-2021-2022/" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Tabenkin H, Oren B, Steinmetz D, Tamir A, Kitai E. Referrals of patients by family physicians to consultants: a survey of the Israeli Family Practice Research Network. Family Practice. 1998;15(2):158-164. https://doi.org/10.1093/fampra/15.2.158", "country_ids": [ "ISR" ], "coverage_domains": [ "authoritative_review", "observed_referral", "patient_flows", "primary_care", "referral_design", "utilization" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "observed", "excerpt": "In 1140 of 10896 (10.5%) visits", "institution": "Family Practice", "locator": { "locator_type": "text_abstract_anchor", "source_word_anchor": "In 1140 of 10896 (10.5%) visits, patients were referred to specialist consultants", "source_word_count": 12 }, "material_id": "material:a91e8ac7a75a95acea9eca17", "notes": [ "Retain the ten-physician, three-month scope; do not generalize it to contemporary Israel." ], "origin": "country-evidence-improvement-sources", "period": "1998 publication; referrals recorded continuously for three months", "publication_date": null, "publication_year": 1998, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "research_literature" ], "source_system": null, "source_version": { "detected_media_type": "text/plain", "response_sha256": "67d7b36408e233c45ab653f9851c3949370b96802bcd1cd4e03e2f8fd3861778" }, "statement": "A three-month study of ten family physicians found specialist referrals in 10.5% of visits. 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