To what extent does the Central Bureau of Statistics’ Health Survey contribute to policy decisions concerning the health system? If designed differently, might it contribute more?
These questions are discussed in a report of the findings from a case study of the Health Survey – one of the principal and most accessible sources of information about health and health care in Israel. This multi-purpose survey is conducted on a large, representative national sample by the Central Bureau of Statistics (CBS), in cooperation with the Ministry of Health. The survey primarily comprises questions about the use of various health services and the presence of certain chronic diseases; each round of the survey has also included additional questions about one or more special topics.
The analysis presented in this report is part of a multi-year study of the role of data and research in significant government decisionmaking related to implementation of the National Health Insurance Law. As a multi-purpose survey, the Health Survey was not originally designed to provide data related to the law. However, the opportunity arose to adapt it to information needs related to the law.
This analysis is based primarily on in-depth interviews with users and potential users of information from the survey, and with those responsible for financing, planning, and conducting it. Three types of use of the survey data were examined, and revealed the following:
Overall monitoring of the health system: The survey contributed considerably to the monitoring of the system, and especially to the analysis of access and equity.
Input into policymaking in ten key decisions related to the National Health Insurance Law: The survey contributed much to one of the ten decisions examined, and somewhat to two additional decisions. However, it made almost no contribution to the other seven decisions.
Assessments of the impact of decisions related to the National Health Insurance Law: To date, data from the survey have not contributed significantly to efforts to assess the impact of NHI-related decisions.
The survey’s contribution to the development of policy and assessment of its impact was limited by its brevity, its insufficient frequency, and incomplete efforts to adapt it to policymakers’ evolving information needs. Thus, while the survey’s contributions may already be sufficient to justify conducting it, this study’s findings suggest that it could contribute more, were it designed differently. The study findings are already helping the Ministry of Health and the CBS modify the survey and develop a multi-year strategy regarding the frequency, length, and focus of future Health Surveys.
The study was funded by the Connie and Bert Rabinowitz Fund for Creative Breakthrough Research at the JDC-Brookdale Institute, and by a grant from the Israel National Institute for Health Policy and Health Services Research.