Israel: a comparison of army personnel satisfaction rates in different primary healthcare settings.

The Israeli medical corps has recently been examining different primary healthcare settings for home-front career army personnel. This study compares the satisfaction rates of this unique population in different primary healthcare settings. Previously validated patient-satisfaction surveys were conducted 4 months apart in 10 large primary care clinics that treat home-front army career personneL. Satisfaction was highest in a civilian hospital-based primary care clinic. The specialized military career personnel clinics produced less satisfaction than the hospital setting, according to the survey; however, the differences were not statistically significant. Patient satisfaction was significantly lower in the classic military-based general practices. The hospital setting of civilian primary care created higher satisfaction in aspects of accessibility, availability, and interpersonal relationships. However, the patients' perception of quality of care was lower than in the other settings.

The prevalence of common cardiovascular diseases among 17-year-old Israeli conscripts.

BACKGROUND: There are only few reports on the prevalence of common cardiovascular disorders among adolescents. The previous studies focused on specific diseases, and screened relatively small samples. OBJECTIVE: The aim of this study was to define the prevalence of different common cardiovascular disorders among 17-year-old Israeli conscripts. A comparison between the morbidity patterns of female and male adolescents was also performed. DESIGN: All 17-years-old Israeli nationals are obliged by law to appear at the Israel Defense Forces Recruiting Office for medical examination except for orthodox religious and Arabic adolescents. Cardiology specialists evaluated and classified nominees with suspected cardiovascular disorders. RESULTS: The most prevalent diagnoses were valvular heart disease (590/ 100,000), syncope (440/100,000), and mitral valve prolapse (340/100,000). The most prominent differences between female and male adolescents were noted in the prevalence of: congenital valvular heart disease, syncope, history of hypertension, supraventricular tachycardia with pre-excitation, myocarditis and pericarditis, and bradycardia and conduction disorders. CONCLUSIONS: The most prevalent cardiac disorders among 17-year-old Israelis were congenital valvular heart disease, syncope and mitral valve prolapse. Some significant differences were noted between the morbidity patterns among male and female adolescents. The higher prevalence of congenital valvular heart disease compared to non-valvular heart disease is surprising. The prevalence of hypertension among Israeli adolescents in the last 15 years remained stable.

Screening for common respiratory diseases among Israeli adolescents.

BACKGROUND: Respiratory diseases are responsible for a significant proportion of serious morbidity among adolescents. There are few reports on the prevalence of common respiratory disorders in this population. The previous studies focused on specific diseases and screened relatively small samples. OBJECTIVE: To define the prevalence of different common respiratory disorders among 17-year-old Israeli conscripts. DESIGN: All 17-year-old Israeli nationals are obliged by law to appear at the Israel Defense Forces recruiting office for medical examination. Respiratory disease specialists evaluated and classified nominees with suspected respiratory disorders. RESULTS: A high prevalence of respiratory morbidity was found among 94,805 17-year-old conscripts (61.5% male, 39.5% female). The most prevalent diagnosis was asthma (in 8% of male and 6.8% of female subjects). Fifty-five per cent of the asthma patients suffered from moderate to severe disease. The prevalence of chronic obstructive pulmonary disease was 0.03% for the male and 0.01% for the female subjects. A difference in morbidity patterns between male and female adolescents was noted, particularly in the prevalence of chest deformation and spontaneous pneumothorax. CONCLUSIONS: The most prevalent respiratory disorder among 17-year-old Israeli conscripts was asthma. One-half of the asthma patients in this study suffered from moderate to severe disease. The prevalence of other respiratory disorders was much lower.

Evaluating delivery of primary health care to military personnel during low-intensity conflict using a patient satisfaction survey.

The delivery of medical health care to soldiers serving in active front units in the Israeli Defense Forces requires the ability to adjust to different military activity settings. This study was conducted to compare patient satisfaction, as a tool for assessing quality of care, in different activity settings: training and Low-intensity conflict setting. A patient satisfaction survey was conducted simultaneously in battalions during low-intensity conflict and training activities. Data analysis showed that patients' perception of the quality of care they received and of medical staff attitude was higher in the conflict setting. Correlation analysis revealed that patients during conflict perceived outcome of care and accessibility as most important in evaluating overall satisfaction. We suggest that perception of high-quality medical care can be obtained during conflict conditions. Interestingly, in the conflict setting, the physical environment of the clinics appears to be less crucial to patient satisfaction than physician availability and medical outcome. These results may serve as a basis for changing health delivery systems by health policy makers.