המכון הלאומי לחקר שרותי הבריאות ומדיניות הבריאות )ע"ר( The Israel National Institute for Health Policy Research THE 5TH INTERNATIONAL JERUSALEM CONFERENCE ON HEALTH POLICY ICC Jerusalem Convention Center, June 3-5, 2013 HEALTH POLICY IN TIME OF AUSTERITY PROVIDER PERSPECTIVES, QUALITY ASSURANCE & PUBLIC ACCEPTANCE PROGRAM & BOOK OF ABSTRACTS CHAIR: Prof. Avi Israeli (IL) & Prof. Alan M. Garber (USA) Dear Colleagues, It is with great pleasure and honor that we welcome you to the 5th Jerusalem International Conference on Health Policy. This conference takes place at a time when societies and governments are still reeling from the aftereffects of the financial crisis that led to widespread recession and exposed underlying weaknesses in the world economic system. Since we began planning this conference, the consequences of lagging economic growth and austerity have been significant and, in some cases dire. Policy makers are searching for new solutions, losing confidence in both conventional Keynesian and monetarist policies. Health systems have not been spared. But, beyond the need to consider ways of dealing with austerity, health systems can also play a leading role in contributing to social vitality and development of new modes of policy, regulation and management that can cope with new realities. The conference was planned to confront the following key challenges: 1. Patterns of Health Care Under Austerity 2. Institutional Governance Strategies 3. Sustaining Quality and Performance 4. Financial and Economic Strategies We have received an outstanding, broad, creative outpouring of abstracts, that, while stimulated by these questions, take us also in new directions, bringing new ideas to the table. And we have assembled leading experts in management and governance, health economics, health policy and regulation, population health, and quality and performance measurement to address the conference on these issues in our plenary sessions. The thematic sessions, reflecting the nature of the abstracts received will, we hope, delve more deeply into these challenging but fascinating problems, and we expect to emerge with new ideas for the future based on the solid contributions of all the participants. We wish you all a successful conference and pleasant stay in Jerusalem. Prof Avi Israeli Prof Alan M. Garber Table of Contents Page No. Scientific and Organizing Committee 6 General Information 7 Scientific Program 9 Biographies 25 Abstracts of Oral Presentations 87 Abstracts of ePoster Presentations 237 Participants 311 Invited Speakers & Chairpersons 313 Speakers 316 Poster Presenters 320 6 Health Policy in Times of Austerity Scientific & Organizing Committee Chair: Prof. Avi Israeli, Ministry of Health & The Hebrew University of Jerusalem - Hadassah, Israel Chair: Prof. Alan M. Garber, Harvard University, USA Prof. Alik Aviram, The Israel National Institute for Health Policy Research, Israel Prof. Haim Bitterman, Clalit Health Services, Israel Prof. Chaim Doron, The Israel National Institute for Health Policy Research, Israel Prof. Josep Figueras, European Observatory & WHO European Centre, Belgium Prof. Kobi Glazer, Tel Aviv University & Boston University, Israel Prof. Dan Greenberg, Ben-Gurion University of the Negev, Israel Mrs. Ziva Litvak, The Israel National Institute for Health Policy Research, Israel Prof. Orly Manor, The Hebrew University of Jerusalem - Hadassah, Israel Prof. Martin McKee, University of London, UK Prof. Shlomo Mor-Yosef, The Israel National Institute for Health Policy Research, (Israel) & National Insurance Institute, Israel Prof. Joseph Pliskin, Ben-Gurion University of the Negev, Israel Prof. Avi Porath, Maccabi Healthcare Services, Israel Prof. Richard Saltmam, Emory University, USA Prof. Richard M. Scheffler, University of California, Berkeley, USA ePoster Committee Chair: Dr. Yehuda Neumark, The Hebrew University of Jerusalem, Israel Prof. Tamy Shohat, Israel Center for Disease Control, Israel Prof. Varda Soskolne, Bar-Ilan University, Israel General Information 7 General Information VENUE ICC Jerusalem Convention Center Adjacent to the Crowne Plaza Hotel Telephone (02) 6558558 REGISTRATION / HOSPITALITY DESKS The Registration / Hospitality Desks will be located at the ICC Jerusalem Convention Center and the Crowne Plaza Hotel, and will be open to coincide with sessions on each day of the Conference. Opening Hours Crowne Plaza Hotel Sunday: 12:00-19:00 Opening Hours ICC Jerusalem Convention Center Monday: 8:00-18:00 Tuesday: 9:00-18:00 Wednesday: 9:00-17:00 ePosters ePosters will be on display in the ePoster area throughout the three days conference. Exhibition hours are: Monday: 9:00-18:00 Tuesday: 9:00-18:00 Wednesday: 9:00-14:00 Awards for Outstanding ePosters will be given at the Closing session on Wednesday, June 5th, between 14:00-16:30. 8 Health Policy in Times of Austerity CONFERENCE BADGE Upon registration, you will receive your conference kit, which will include your conference badge. You are requested to wear your conference badge at all sessions and social events. In addition, you will receive entry passes to the conference lunches. LANGUAGE English is the official language of the conference. CLOTHING Dress is informal for all occasions. OPTIONAL SIGHTSEEING TOURS There are a large variety of sightseeing tours available. For further information and reservations, please contact the Hospitality / Registration Desk. SOCIAL EVENTS Welcome Reception: Sunday, June 2nd 2013, 20:00 - 22:00. Departure for the Reception will be from the lobby of The Crowne Plaza Hotel at 19:30. Scientific Program 9 The 5th International Jerusalem Conference On Health Policy ICC Jerusalem Convention Center, June 3-5, 2013 HEALTH POLICY IN TIMES OF AUSTERITY Provider Perspectives, Quality Assurance & Public Acceptance Sunday, June 2, 2013 20:00 Welcome Remarks: Richard B. Saltman (USA) Has Austerity Moved the Goalposts? Monday, June 3, 2013 09:00-11:00 Opening Session Chair: Avi Israeli (IL) & Alan M. Garber (USA) Greetings: Shlomo Mor-Yosef (IL) Nir Barkat, Mayor of Jerusalem (IL) MK Yael German, Minister of Health (IL) Alan M. Garber (USA): The American Quest to Control Health Expenditure Growth Sherry Glied (USA): Health Policy Reform in an Era of Austerity - Lessons From Washington, DC Ronni Gamzu (IL): What is the Next "Arrow" in the Quiver: 50 Years of Uncertainty and Medical-Care Economics 11:00-11:30 Coffee Break - ePoster Exhibit 11:30-13:30 Plenary Session - Group A: Patterns of Health Care Under Austerity Chair: Dan Greenberg (IL) David Stuckler (UK): The Body Economic: Why Austerity Kills Martin McKee (UK): How have European Health Systems Responded to the Financial Crisis Stephen C. Schoenbaum (USA): Achieving an Efficient Health Care System; Focus on Patients and Workforce Gary L. Freed (USA): Impact of the "Ageing of America" on Pediatric Health Care 13:30-14:30 Lunch Break 14:30-16:00 Parallel Session 1 16:00-16:30 Coffee Break - ePoster Exhibit 10 Health Policy in Times of Austerity 14:30-16:00 Parallel Session 1 Group A - Oren Hall 1 Group B - Oren Hall 2 Group C - Oren Hall 3 Group D - Oren Hall 4 Patterns of Health Care Under Austerity Institutional Governance Strategies Sustaining Quality and Performance Financial and Economic Strategies Public Health: Vaccination Policy Dealing with Complex Patient Choosing Wisely: Re-Evaluating Risk and Health Insurance Routine Tests and Procedures Chair: Salman Zarka Chair: Avi Porath Chair: Orly Manor Chair: Ehud Kokia & Moshe Bar Siman Tov 1. Baruch Velan (IL) 1. Richard B. Saltman (USA) 1. Ora Paltiel (IL) 1. Shlomo Mor-Yosef (IL) VACCINATION IN TIMES OF AUSTERITY PUBLIC HOSPITAL GOVERNANCE IN EUROPE: MAKING "WISE" CHOICES: WHY AND HOW INEQUALITY IN PRIVATE HEALTH REVIEWING INNOVATIVE STRATEGIES EXPENDITURE IN ISRAEL: TRENDS IN THE PAST DECADE AND THE CASE OF EXEMPTION FROM CO-PAYMENT 2. Anat Amit Aharon (IL) 2. Ran D. Balicer (IL) 2. Amnon Lahad (IL) 2. Alberto Holly (Switzerland) REASONS WHY PARENTS DO NOT COMPLY TACKLING THE FINANCIAL AND WHERE WE SHOULD NOT PUT OUR TIME HEALTH AND HEALTH CARE DEMAND WITH RECOMMENDED PEDIATRIC VACCINES ORGANIZATIONAL CHALLENGES OF AN AND MONEY IN PRIMARY CARE EFFECTS OF DOUBLE COVERAGE AGING MULTI-MORBID POPULATION: THE NATIONAL PERSPECTIVE 3. Lisa Rubin (IL) 3. Sara Rosenbaum (USA) 3. Gil Siegal (IL) 3. Amir Shmueli (IL) LINKING CHILD PAYMENT SUBSIDIES TO HOW HEALTH REFORM EFFORTS IN THE U.S. A LEGAL PERSPECTIVE ON WISDOM, ON THE CALCULATION OF THE ISRAELI RISK IMMUNIZATIONS - AN EXPERIMENT IN HISTORICALLY HAVE DEALT WITH CHILDREN CHOICES & REVEALED PREFERENCES ADJUSTMENT RATES PUBLIC POLICY AND ADULTS WITH DISABILITIES 4. Natalie Gavrielov-Yusim (IL) 4. Ephraim Shapiro (IL) 4. Carolyn M. Clancy (USA) 4. Richard C. van Kleef (Netherlands) THE OUTCOMES OF VARICELLA VACCINE COMMUNITY HEALTH WORKERS AND DISCUSSANT HOW CAN REGULATORS MEASURE RISK ADOPTION IN THE POPULATION UNDER CHRONIC DISEASE PREVENTION AND SELECTION IN COMPETITIVE HEALTH PRIVATE PURCHASE POLICY CONTROL: EFFECTIVE AS WELL AS LESS INSURANCE MARKETS? COSTLY? 5. Preeti Kumar (India) 5. Chandra Cohen (IL) 5. Bruce E. Landon (USA) 5. Shuli Brammli-Greenberg (IL) IMPROVING GOVERNANCE AND HIGH-RISK CASE IDENTIFICATION FOR THE VALUE OF LOW VALUE LISTS: USING WAITING TIMES AS A TOOL FOR INSTITUTIONAL STRUCTURES TO REDUCE COMPREHENSIVE COMPLEX CARE MOVING FROM LISTS TO IMPLEMENTABLE RATIONING CARE IN A MANAGEMENT CARE INEQUALITY IN IMMUNIZATION IN INDIA MANAGEMENT STRATEGIES SETTING: IS IT A GOOD IDEA, AND IF SO, FOR WHOM? 6. Hadar Arditi-Babchuk (IL) 6. Abla