title: Inequalities in a National Health Care System From the Perspective of Social Workers in Israel.
abstract: This study explores social workers' perceptions of inequalities in Israel's national health care system. Unlike previous studies, which relied on patients' and practitioners' reports, it is based on interviews with 60 social workers in hospitals and ambulatory clinics. The findings show that although Israeli law provides for (almost) free, universal medical care, the treatment of persons lacking in money, education, and social affiliation may be compromised by difficulties in paying for medications, treatments, and travel to and from hospital; by difficulties in understanding doctors' instructions; and by reluctance to ask questions. Most doctors tend to focus exclusively on patients' medical needs, seem to lack sympathy with less educated patients, have little understanding of the life circumstances that impinge on their compliance, and make little effort to speak to them in the language they can understand. Practical suggestions are made with regard to the need to turn doctors' attention to their patients' non-medical needs.
authors.affiliation: 1 Bar-Ilan University, Ramat Gan, Israel.
authors.forename: Nehami
authors.initials: N
authors.lastname: Baum
authors.affiliation: 2 Meuhedet Health Services, Tel Aviv, Israel.
authors.forename: Yishay
authors.initials: Y
authors.lastname: Kum
authors.affiliation: 3 Clalit Health Services, Tel Aviv, Israel.
authors.forename: Hani
authors.initials: H
authors.lastname: Shalit
authors.affiliation: 4 Ministry of Health, Tel Aviv, Israel.
authors.forename: Malka
authors.initials: M
authors.lastname: Tal
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D007557:Israel; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000458:organization & administration*; D010361:Patients / Q000523:psychology*; D010820:Physicians / Q000523:psychology*; D011369:Professional-Patient Relations; D000068217:Social Workers / Q000523:psychology*; D012959:Socioeconomic Factors
keywords: Israel; access to medical care; compliance; doctor–patient communication; health inequalities; low SES patient; qualitative methodology