Patterns of client complaints in Israel's healthcare system

Objectives: Israel's National Health Law of 1994 established the rights of citizens to receive quality health services. The Law set several mechanisms for treating clients' complaints. This study examined complaint patterns and reasons, complaint channels, and knowledge regarding complaints among citizens insured by Israeli health services, with the goal of contributing to the usage of complaints as a tool for improving medical services to citizens. Method: The study was conducted using a telephone survey, with national probability sample of N=1500 respondents aged 21 +Findings: About 75% of respondents did not have a cause to complain over the last 12 months, 25% reported a cause to complain, but only 9.5% (143 of 1500) actually complained. Approximately half of the causes for complaint concerned structural problems such as payments, waiting lists or eligibility. Causes regarding processes and interactions, or medical treatment and its outcomes, each accounted for a quarter of causes. Most complainers, about 75%, submitted their grievances informally at the local level. Only a minority (17%) appealed to official bodies established by Israel's National Health Law at the Ministry of Health or at the HMOs. Clients' awareness regarding rights to complain was found to be low. Conclusions: There is a need to improve clients' knowledge and change complaint patterns, develop means for analyzing existing knowledge about client complaints already available to front-line employees. Furthermore, there is a need to plan organizational mechanisms for capturing and using future complaints submitted on a local level or informally, which are the bulk of the complaints.