Preventive service delivery for children in a managed care environment: contrasts and lessons from Israel.
This document describes the Israeli models of preventive health care delivery focusing on the incorporation of preventive health services into a regulated managed care approach. It also addresses the risks and advantages of such changes and provides recommendations on the direction of public health practice in the US and Israel. Preventive services in Israel are provided by the Ministry of Health or its designees through a system of mother and infant neighborhood clinics called Tipat Halav which are similar to public health clinics in the US. In assessing the exportability of programs on preventive health care such programs must be viewed in the context of societal and cultural perspective of the `importing country. In this regard this document demonstrates that the effective Israeli system of Tipat Halav could not likely be imported into the US successfully. Three factors account for this: the existing political imperatives/trends accepted patterns of care delivery and structure of managed care delivery. Hence it is recommended that the US must take deliberate steps to ensure that the changes of responsibility for preventive services must be handled appropriately. Moreover a new payment structure must be instituted to deliver such services to an increasing percentage of their enrollees.