Document Detail

Factors affecting primary care physicians' perceptions of health system reform in Israel: professional autonomy versus organizational affiliation.
MedLine Citation:
PMID:  17218046     Owner:  NLM     Status:  MEDLINE    
This paper examines primary care physicians' perceptions of a National Health Insurance Law that introduced managed competition into Israel's health care system, and the factors affecting their perceptions. Between April and July 1997, we conducted a mail survey of primary care physicians employed by Israel's four health plans (which are managed care organizations). Eight hundred questionnaires were returned, representing a response rate of 86%. The findings indicate that, overall most physicians support the components of the National Health Insurance Law with statistically significant differences among physicians by health plan. Multivariate analysis revealed that, contrary to theoretical expectations, a perceived decrease in professional autonomy and in the status of the profession following reform did not significantly affect attitudes toward national health insurance. These findings highlight the need for additional empirical studies to further examine theoretical contentions about the implications of infringing on the professional autonomy and the dominant status of physicians. The principal and most interesting finding of this study was the independent effect of health plan affiliation on physicians' attitudes toward each of the five components of the National Health Insurance Law, after controlling for background characteristics, for the reform's perceived effect on the physicians' autonomy and status in the health plan, and for the reform's perceived effect on the level of health plan services and the health plan's financial situation. We found that physicians' perceptions tended to conform to the formal position of their health plan, suggesting the need to analyze the attitudes of physicians in their organizational context, rather than treating them as members of a uniform professional community.
Revital Gross; Hava Tabenkin; Shuli Brammli-Greenberg
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Publication Detail:
Type:  Journal Article     Date:  2007-01-10
Journal Detail:
Title:  Social science & medicine (1982)     Volume:  64     ISSN:  0277-9536     ISO Abbreviation:  Soc Sci Med     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-03-12     Completed Date:  2007-05-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8303205     Medline TA:  Soc Sci Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  1450-62     Citation Subset:  IM    
Myers-JDC-Brookdale Institute, Jerusalem, Israel.
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MeSH Terms
Attitude of Health Personnel
Data Collection
Health Care Reform*
Middle Aged
Organizational Affiliation*
Physicians, Family / psychology*
Professional Autonomy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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