Primary care physicians’ perceptions of Israel’s quality monitoring program – 2010 and 2020

Abstract

Abstract Background: Monitoring the quality of primary care is essential for improving healthcare services. The National Program for Quality Indicators in Community Healthcare in Israel was launched in 2000 to assess and enhance primary care services. The program measures various aspects of healthcare quality, and its effectiveness depends on the perceptions and attitudes of primary care physicians. A 2010 survey of Israeli primary care physicians found widespread support for the program, alongside concerns about its effects on workload and competitiveness. In the wake of those findings, the leadership of the quality monitoring program and several health plans reported instituting measures to mitigate the program’s unwanted side effects. This study assessed the extent to which physicians’ perceptions had changed between 2010 and 2020. The study specifically sought to investigate physicians' experiences with the program, their perspectives on quality indicators, and the program's impact on their work and patient care. Methods: Surveys in 2010 and 2020 gathered data from primary care physicians employed by health plans in Israel. Stratified random sampling ensured representation across healthcare settings. The study sample comprised 605 physicians in 2010 and 405 physicians in 2020. The questionnaires collected data on physicians' experiences, perceptions, challenges, and suggestions related to the quality monitoring program. Results In both rounds of the survey, most of the physicians considered the quality monitoring program important or vital (88% of the physicians in 2010, 81% of them in 2020). However, concerns were raised about excessive managerial pressures (63% of study population in 2010, 58% in 2020), increased workloads (47-48% in both surveys), and over-competitiveness (58% in 2010, 60% in 2020) associated with the program. Conclusions: The study indicates that while support for the program in general remains high, it continues to have undesirable side effects. The steps taken to mitigate those side effects apparently had little effect or were offset by other developments. The leaders of the quality monitoring program and the health plans should take additional steps to address these side effects.