Healthy Israel 2020: a visionary national health targeting initiative.

This article describes the development of a national health targeting initiative entitled 'Healthy Israel 2020' which was created to enhance the health and wellbeing of Israelis through a variety of health promotion and disease prevention interventions. This initiative builds upon the experience of two major worldwide targeting efforts, "Health People 2010" of the US and the World Health Organization's Health21', as well as lessons learned from other countries. Important philosophical underpinnings are highlighted, particularly the evidence-based nature of the process. Real-world organizational and policy challenges and creative solutions are presented. It is hoped that this report will be of value to others in Israel and elsewhere who are interested in improving the health of their nations.

Cost evaluation of two methods of post tooth extraction hemostasis in patients on anticoagulant therapy.

The classical management of patients on oral anticoagulant therapy included hospitalisation, cessation of the anticoagulant agent, and extraction of teeth when the prothrombine levels rise. This method was substituted in the High Risk Dental Clinic at Barzilai Medical Center in Ashkelon by use of a tissue sealant (Tisseel) which does not need hospitalisation nor cessation of the anticoagulant therapy. In comparing the last 23 sessions employing the former method to the first 23 sessions using the new method there were significant differences in the cost effectiveness for the health system, provider, insurer and patient. Despite the fact that from the health system point of view the new method is much more cost effective, there is no financial incentive for the provider (hospital) nor awareness on the part of the insurer (General Sick Fund) to embrace it and 'market' it.