The patient as a client: a model for evaluation of Israel Defense Forces

The Israel Defense Forces (IDF) Medical Corps provides medical services-routine and emergency--to all IDF personnel (conscripts, career personnel, and reservists). Despite the fact that there are no differences in prevalence of disease in the IDF compared with the civil sector, health consumer appraisal, in the military, of the medical services they receive during peacetime at IDF medical clinics is not high. The objective of this research was to develop an effective and differential tool for monitoring the quality of medical service at IDF clinics drawn from service quality indexes based on the perspective of the soldier patient. The research tool used was an anonymous questionnaire comprised of five demographic questions and 21 components of quality index measurements that participants were asked to rank in terms of importance during a visit to their IDF medical clinic. Those categories found to influence the client's perception of quality medical service were accessibility and availability of services, information provided by the clinic, and the efficiency of staff. The factors found to be less influential in the clients' perceptions of quality were staffing and infrastructure. Quality control using these significant indexes will allow monitoring programs to focus on components that are important from the soldier's perspective, without overlooking other significant aspects of the soldier's perceptions of the quality of medical service as a client.