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Decentralization in a sick fund: lessons from an evaluation.

R Gross¹, B Rosen

¹JDC-Brookdale Institute, Jerusalem, Israel.

Journal of Management in Medicine

|December 9, 1995

Summary

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Decentralization efforts in Israel

Area of Science:

Healthcare Management
Organizational Change
Public Health Policy

Background:

Israel's largest sick fund initiated a decentralization process in 1988.
Authority was delegated from central management to two regional demonstration sites.

Purpose of the Study:

To assess the implementation extent of the decentralization plan.
To identify key challenges encountered during implementation.
To evaluate the overall process of organizational change.

Main Methods:

The study involved an in-depth evaluation of the decentralization process within the selected demonstration sites.
Analysis focused on the extent of plan implementation and associated difficulties.

Main Results:

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The decentralization program was only partially implemented.
Significant implementation challenges were identified during the process.

Conclusions:

Clear division of responsibilities, robust control instruments, and improved managerial skills are crucial for successful decentralization.
Establishing dedicated implementation teams and joint forums aids problem-solving.
Clarifying organizational policy is essential for sub-unit operational success.