Outsourcing primary medical care in Israeli defense forces: Decision-makers' versus clients' perspectives

Background: Decision-makers in the Israeli defense force (IDF) have determined that the Medical Corp (MC) would outsource the primary care services required by career soldiers to a skilled civilian health care provider, in an attempt to improve efficiency, quality and "image" of the MC care system, while controlling expenses. Methods: A cross-sectional survey to reveal decision-makers' considerations for outsourcing primary care for career soldiers and to evaluate whether these considerations match career soldiers' satisfaction level parameters was conducted between February 2002 and 2003 in IDF bases and civilian primary care clinics. Results: Medical Corp decision-makers are concerned about loss of professional prestige and dependence on the civilian system. A high level of satisfaction following outsourcing was found among career soldiers due to: medical staff attitude, pleasant facilities, quality of care, availability and accessibility of medical care. Agreement about five factors was found among decision-makers and career soldiers: working environment, medical personnel attitude, quality and availability of medical care, and patient satisfaction level. Conclusions: Outsourcing of primary care from military to civilian providers gives high client satisfaction level.