Use of medical care by children during a physicians' strike

From March through June 1983 the almost 8,000 physicians in the public sector in Israel were on strike. While emergency hospital care was assured, primary care options were severely limited, and the Alternative Medical Service set up by the Israel Medical Association involved a significant payment at the time of visit. This constituted a radical change from the no-charge physician care regularly provided to the insured population in the community clinics. A study was conducted in the third month of the strike to assess the utilization of care for children. The results of interviews with 253 families registered in eight Sick Fund clinics showed that the majority of parents who reported a child's illness did not defer seeking care. The first sources of care were the nurses in the community clinic and the hospital emergency room, while care from physicians working privately was used to the same extent as the Alternative Medical Centers. These results indicate that the relatively high utilization patterns of this population were not significantly changed. Differences in the first source of care by clinic suggest that socioeconomic factors and the availability of the various options are related to use in each area. These factors, as well as the threshold for seeking care and the influence of selection, should be examined in more detail to develop appropriate utilization patterns and a more rational use of resources.