Service users' perspectives of social treatment in social service departments in Israel: Differences between standard and poverty-aware treatments.

This article uses mixed methods to examine service user satisfaction with social work treatment in social services departments (SSDs) in Israel-its level, the factors that influence it and its experiential dimensions. A total of 235 service users (SUs) from 11 SSDs were interviewed for this study. They were divided into three groups: (a) SUs receiving standard treatment; (b) SUs participating in poverty-aware programs and (c) SUs receiving a poverty-aware standard treatment. The quantitative findings indicated a significant higher level of satisfaction among the SUs who had been included on poverty-aware programs or received a poverty-aware standard care compared to SUs who had received standard treatment. Additionally, high reported levels of satisfaction were influenced by the frequency of meetings between the service user and the social worker, while the history of care in the SSD had no apparent impact on satisfaction levels. The qualitative analysis indicated that high levels of satisfaction were linked to the service user perceiving the social worker as active, supportive and respectful, and as responsive to the user's emotional and material needs. These findings are discussed in the context of the Poverty-Aware Paradigm and relationship-based social work.

Unemployment among younger and older individuals: does conventional data about unemployment tell us the whole story?

In this research we show that workers aged 30-44 were significantly more likely than those aged 45-59 to find a job a year after being unemployed. The main contribution is demonstrating empirically that since older workers' difficulties are related to their age, while for younger individuals the difficulties are more related to the business cycle, policy makers must devise different programs to address unemployment among young and older individuals. The solution to youth unemployment is the creation of more jobs, and combining differential minimum wage levels and earned income tax credits might improve the rate of employment for older individuals.

The Price of a Neglected Zoonosis: Case-Control Study to Estimate Healthcare Utilization Costs of Human Brucellosis.

Human brucellosis has reemerged as a serious public health threat to the Bedouin population of southern Israel in recent years. Little is known about its economic implications derived from elevated healthcare utilization (HCU). Our objective was to estimate the HCU costs associated with human brucellosis from the insurer perspective. A case-control retrospective study was conducted among Clalit Health Services (CHS) enrollees. Brucellosis cases were defined as individuals that were diagnosed with brucellosis at the Clinical Microbiology Laboratory of Soroka University Medical Center in the 2010-2012 period (n = 470). Control subjects were randomly selected and matched 1:3 by age, sex, clinic, and primary physician (n = 1,410). HCU data, demographic characteristics and comorbidities were obtained from CHS computerized database. Mean±SD age of the brucellosis cases was 26.6±17.6 years. 63% were male and 85% were Bedouins. No significant difference in Charlson comorbidity index was found between brucellosis cases and controls (0.41 vs. 0.45, respectively, P = 0.391). Before diagnosis (baseline), the average total annual HCU cost of brucellosis cases was slightly yet significantly higher than that of the control group ($439 vs. $382, P<0.05), however, no significant differences were found at baseline in the predominant components of HCU, i.e. hospitalizations, diagnostic procedures, and medications. At the year following diagnosis, the average total annual HCU costs of brucellosis cases was significantly higher than that of controls ($1,327 vs. $380, respectively, P<0.001). Most of the difference stems from 7.9 times higher hospitalization costs (p<0.001). Additional elevated costs were 3.6 times higher laboratory tests (P<0.001), 2.8 times higher emergency room visits (P<0.001), 1.8 times higher medication (P<0.001) and 1.3 times higher diagnostic procedures (P<0.001). We conclude that human brucellosis is associated with elevated HCU costs. Considering these results in cost-effective analyses may be crucial for both reducing health inequities and optimal allocation of health systems' scarce resources.