title: Israel's expenditure on health services.
abstract: In 1986, the State of Israel utilized 7.6% of its gross national product (GNP) for health care. At first glance this seems to be a reasonable level of expenditure when compared with the percentage of GNP devoted to health care in eight selected industrialized non-communist nations. However, Israel devoted fewer dollars per citizen on health care than any of the eight other nations. We investigate the role of three factors that contributed to this relatively low expenditure level: a) health personnel and bed supply levels, b) operations and procedure rates, and c) relative wage costs of health personnel. If Israel had the same level of per capita GNP as the USA, its annual health service per capita expenditure would increase from $472 to $1,328. If, in addition, its health personnel received the same wage differentials (in relation to the average wage levels) as those received by health personnel in the USA, it is estimated that Israel would spend around $1,842 annually per capita on health care (representing 10.7% of its GNP). This figure is only $98 less than what the USA spends, and creates a vastly different impression concerning the efficiency of the health system than does the original unadjusted expenditure of only $472 per head, which is $1,468 less than that spent by the USA. The Israeli health system can be said to be characterized by adequate manpower inputs, high bed occupancy rates, low surgery rates relative to the USA (not necessarily a negative phenomenon), and low relative wage inputs. The relatively limited available output indicators lead us to believe that productivity per person employed in the health services could be raised. The low absolute levels of health expenditures in Israel are mainly due to a combination of a low GNP per head and relatively low wage differentials between health service staff and other income earners.
authors.affiliation: Department of Social Medicine, Hebrew University-Hadassah School of Public Health and Community Medicine, Jerusalem, Israel.
authors.forename: G
authors.initials: G
authors.lastname: Ginsberg
authors.forename: A
authors.initials: A
authors.lastname: Israeli
authors.forename: S
authors.initials: S
authors.lastname: Penchas
mesh_terms: D001509:Bed Occupancy; D003954:Diagnostic Services / Q000191:economics; D005251:Fees, Medical; D005102:Health Expenditures; D006296:Health Services / Q000191:economics*; D006280:Health Workforce / Q000191:economics / Q000600:supply & distribution; D006801:Humans; D007557:Israel; D012456:Salaries and Fringe Benefits; D013514:Surgical Procedures, Operative / Q000191:economics / Q000706:statistics & numerical data; D014481:United States