The data presented is based on information provided by the four health plans (Kupot Cholim) operating in Israel. The Kupot Cholim voluntarily submit this information to the program administration as part of their active participation in the Quality Health Indicators Program.
The data is aggregated and completely anonymous, containing no identifying information. This format ensures strict adherence to patient confidentiality.
Data collection is based on the computerized databases of the Kupot Cholim, enabling the examination and monitoring of various indicators by age group, gender, socio-economic status, and residential district.
The report is based on data from the computerized databases of each of the four health plans, covering the entire insured population—all residents of the State of Israel, with the exception of soldiers and prisoners. For each study period, individuals who did not complete a full year of membership in a given health plan were excluded. This includes those who died or were born during the year, those who switched between health plans within the same year, and individuals who were abroad for more than two years.
For several measures, data collection occurs during routine primary care visits. This does not constitute a substantial data limitation, as evidenced by a study conducted among Clalit Healthcare members, which demonstrated that the majority of insured individuals utilize primary care services regularly: over 90% have at least one annual visit, and 97% have at least one visit within a five-year period [1].
The rates of the measures presented in the program are based on data from the entire population, not a sample, and therefore, there is no sampling error. However, other sources of error may exist in the data. The data production method includes a comprehensive set of tests and validation of the data, utilizing various sources of information.
For all measures, data are reported for the entire relevant population and stratified by year, gender, age group, socioeconomic status, and geographic region.
Socioeconomic Status (SES) is determined based on the cluster classification of the statistical area corresponding to the individual’s residential address. Following each national census, the Central Bureau of Statistics assigns socioeconomic scores to Statistical Geographic Areas based on census data. This classification is further refined by POINTS, a commercial system that enhances and updates SES scoring using additional data sources, including consumer data from commercial entities, real estate prices, and current demographic publications. POINTS also ensures full coverage by assigning socioeconomic clusters to all residential areas, including new neighborhoods not yet classified by the Central Bureau of Statistics [2].
All four Israeli health plans integrate POINTS data into their records. SES is provided to the national program on a standardized scale from 1 to 10 for each individual included in the measure. Approximately 3% of insured individuals had incomplete residential address information and were therefore excluded from SES-based analyses due to the inability to determine their SES classification.
To simplify data presentation, the original socioeconomic status (SES) scores, ranging from 1 to 10, were consolidated into four groups of approximately equal population size. Group 1, representing the lowest SES, includes scores 1 to 3 and accounts for 22% of the population. Group 2 comprises scores 4 to 5 and represents 27.3% of the population. Group 3 includes scores 6 to 7 and covers 28.1% of the population. Group 4, representing the highest SES, includes scores 8 to 10 and constitutes 19.7% of the insured population.
Some measures are also shown by district. Each district encompasses multiple settlements.
healthcare system defines 20 administrative districts. A breakdown of settlements with populations over 30,000 residents and their corresponding districts is provided below:
Golan Heights
Safed: Safed (including the Upper Galilee settlements and Kiryat Shmona)
Acre: Nahariya, Acre, Karmiel, Shefa-‘Amr, Tamra, and Sakhnin
Nazareth: Nazareth and Nof HaGalil
Kinneret: Tiberias
Jezreel: Afula and Migdal HaEmek
Haifa: Haifa, Kiryat Ata, Kiryat Motzkin, Kiryat Bialik, Kiryat Yam, and Tirat Carmel
Hadera: Hadera, Umm al-Fahm, Pardes Hanna-Karkur, Harish, and Baqa al-Gharbiyye
Sharon: Netanya and Tayibe
Petah Tikva: Petah Tikva, Kfar Saba, Ra’anana, Rosh HaAyin, Hod HaSharon, El’ad, Yehud, and Givat Shmuel
Tel Aviv: Tel Aviv-Yafo, Herzliya, and Ramat HaSharon
Ramat Gan: Bnei Brak, Ramat Gan, Givatayim, Kiryat Ono, and Or Yehuda
Holon: Holon and Bat Yam
Ramla: Modi’in-Maccabim-Re’ut, Lod, Ramla, and Be’er Ya’akov
Rehovot: Rishon LeZion, Rehovot, Yavne, Nes Ziona, and Gedera
Jerusalem: Jerusalem and Beit Shemesh
Judea and Samaria: Modi’in Illit, Beitar Illit, and Ma’ale Adumim
Ashkelon: Ashdod, Ashkelon, and Kiryat Gat
Western Negev: Ofakim, Netivot, Rahat, and Sderot
Be’er Sheva: Be’er Sheva, Eilat, Dimona, and Arad
[1] Rosen D, Nakar S, Cohen AD, Vinker S. Low rate of non-attenders to primary care providers in Israel – a retrospective longitudinal study. Isr J Health Policy Res. 2014; 3: 15.
[2] 2022 Characterization of Geographic Units and Their Classification by the Socio-Economic Level of the Population in 2019. Central Bureau of Statistics.
https://www.cbs.gov.il/he/mediarelease/DocLib/2022/375/24_22_375b.pdf