RESUMO
In Israel, considerable gaps are found on all quality and other measures of health between the north and south districts and Israel's center. Although the Ministry of Health leads a policy of reducing the existing gaps in medical services in the periphery, not enough has yet been done. The conclusions of various committees strove to narrow these gaps but none have been implemented. In this article we propose a new paradigm, pooling resources and other proposals to improve health care services in the north and south districts of Israel.
Assuntos
Atenção à Saúde/organização & administração , Melhoria de Qualidade/organização & administração , Qualidade da Assistência à Saúde , Atenção à Saúde/normas , Disparidades em Assistência à Saúde , Humanos , IsraelRESUMO
INTRODUCTION: The natural history of precancerous lesions and cervical cancer in Israeli women differs from that reported in the world. In 2011, 244 women were diagnosed in Israel with invasive cervical cancer, with the mortality of 79 women. The incidence of cervical cancer in Israel is about 5 new cases per year per 100,000 women (5.4 Jewish, 3.2 Arab). This figure is very low compared with statistics presented in other countries and has not changed over the last decades. The vast majority of Israeli women were diagnosed due to symptoms and not following Pap smear screening. The mortality rate in Israel is similar to that of other OECD countries. In Israel, 71% of patients survive five years or more, the rate is not significantly different from the percentage of survival of other OECD countries. Over half of the Israeli patients are diagnosed in the late stage disease. This delay in cervical cancer diagnosis is probably due to the lack of a national screening program. We recommend more efficient routing of national expenditure for cervical cancer screening and prevention in Israel, scanning asymptomatic women and targeting disadvantaged populations. By applying the proposed screening strategy, redirection of resources will reduce cervical cancer morbidity and mortality, and will increase the percentage of women from low socioeconomic populations tested in Israel.