Homepage > Research abstracts > Disparities in Access to Voice Mechanisms for Realizing Rights in the Israeli Healthcare System: How Can the Gap Between the Periphery and the Center Be Reduced?
Disparities in Access to Voice Mechanisms for Realizing Rights in the Israeli Healthcare System: How Can the Gap Between the Periphery and the Center Be Reduced?
Researchers: Avishai Benish1, Sharon Gilad1, Roni Porat1
- Hebrew University of Jerusalem
Objectives: This study examined the factors explaining variation in the willingness of citizens from different groups — the general Jewish society, Israeli Arabs, and former Soviet Union (FSU) immigrants — to file a complaint with their HMO or the Public Complaints Commissioner when their request for coverage of a medical service is denied.
Method: The study combined a quantitative survey (N=2,122) that included questions about real-world exposure to healthcare service denials, two experiments on a hypothetical denial scenario, and 38 qualitative interviews.
Findings: The findings indicate that 44% of respondents experienced denial of coverage for a medical service request in the past five years, a rate higher than found in previous studies. Administrative self-efficacy — citizens' belief in their ability to navigate the system — emerged as a consistent predictor of their willingness to demand explanations and file complaints, more so than objective information about complaint procedures or trust in the HMO and the Ministry of Health. Hebrew language proficiency was also found to be a central factor explaining inter-group differences. The first experiment examined whether perceiving the HMO as having broad versus limited discretion in covering medical services affects the tendency to complain. Israeli Arabs and FSU immigrants attributed relatively limited discretion to HMOs, but this difference did not explain variation in complaint behavior across individuals and groups. The second experiment tested the effect of assumed success rates when filling a
complaint — 2.5%, 10%, and 40% — on willingness to complain. Information indicating a success rate of 10% or higher increased this willingness, though the effect was contingent on the individual's level of administrative self-efficacy and was limited to Jewish respondents.
complaint — 2.5%, 10%, and 40% — on willingness to complain. Information indicating a success rate of 10% or higher increased this willingness, though the effect was contingent on the individual's level of administrative self-efficacy and was limited to Jewish respondents.
Recommendations: The findings point to the need for targeted interventions to raise awareness of complaint success rates and strengthen the sense of self efficacy among disadvantaged populations.
Research number: 2022/105 A
Research end date: 03/2026