title: Outsourcing of primary care: satisfaction level in the Israeli Defense Forces.
abstract: OBJECTIVE
  To examine the effect of outsourcing primary care services on satisfaction levels among career soldiers in the Israeli Defense Forces (IDF).
  
  
  METHODS
  Data were acquired via self-administered satisfaction questionnaires during the visits of soldiers and civilians to primary care clinics in military bases, hospitals, and HMO settings. Multivariable analyses (GLM) used the SAS statistical program.
  
  
  RESULTS
  Two hundred thirty civilians and 618 soldiers (200 in hospital clinics, 277 in military clinics, and 141 in HMO clinics) completed 848 questionnaires. Gender did not influence satisfaction level (alpha < 0.05). Age and rank influenced two parameters: surroundings (p = 0.0277) and availability of the medical service (p = 0.0368). Location (hospital clinic, HMO clinic, and military clinic) was the primary variable influencing and predicting satisfaction level (11.6%). "Quality of medical care" predicts only 4% of satisfaction level. Soldiers in HMO settings expressed a higher degree of satisfaction particularly in availability of service, quality of service, general satisfaction, and courtesy.
  
  
  CONCLUSIONS
  Career soldiers in Israel value all aspects of primary care given by a civilian HMO and are willing to accept a change (outsourcing primary care to a civilian provider). As a result, decision makers should expand the provision of these services to all career soldiers in Israel. Outsourcing of medical services can serve as a model to military corps worldwide.
authors.affiliation: Military Health Services, IDF Medical Corps, Health Services Center, IDF Medical Corps, Medical Post No. 01960.
authors.forename: Racheli
authors.initials: R
authors.lastname: Magnezi
authors.forename: Ron
authors.initials: R
authors.lastname: Kedem
authors.forename: Haim
authors.initials: H
authors.lastname: Reuveni
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007557:Israel; D008297:Male; D008875:Middle Aged; D008887:Military Medicine / Q000458:organization & administration* / Q000592:standards; D008889:Military Personnel / Q000523:psychology*; D020416:Outsourced Services; D017060:Patient Satisfaction; D011320:Primary Health Care / Q000458:organization & administration* / Q000592:standards; D011446:Prospective Studies; D011795:Surveys and Questionnaires