Issue: № 7, 2025
Doi: https://doi.org/10.37634/efp.2025.7.12
In the context of global population aging, the issue of effective resource management in the healthcare sector is gaining strategic importance. Delays in providing medical assistance to older adults not only deteriorate their physical condition and increase hospitalization rates but also impose a growing financial burden on households and long-term care systems. Moreover, unpredictable expenses and rising demand for specialized care complicate budget planning at both micro and macro levels. The purpose of the paper is to analyze the waiting time for medical care among older individuals in Israel and to assess the socio-economic consequences of such delays for the care system. The study also seeks to develop managerial solutions for system optimization, with particular attention to the critical transition from home-based to institutional care, which requires substantial financial and organizational resources. The paper examines systemic, economic, and administrative factors contributing to delays in care provision – namely, inefficient coordination between services, underfunding of primary healthcare, and the underdevelopment of long-term care infrastructure. A cross-sectional survey of 307 family members of elderly individuals identified key risks: increased caregiving costs, caregiver burnout, and a decline in patients’ quality of life. Involving patients in the decision-making process produced mixed results: while it extended the time required for administrative decisions, it also improved satisfaction with home-based care services. At the same time, individuals with higher education levels demonstrated greater critical attitudes toward the quality of care provided. The worsening physical condition of older adults increased the need for intensive daily care, directly impacting the financial burden on both the state and individual households. Reduced mobility further elevated the demand for specialized equipment and services, adding pressure to the social welfare system. The findings highlight the urgent need for the development and implementation of an effective management model to coordinate healthcare and social services. This includes early identification of patient needs, financial support for caregiving families, and flexible budgeting for long-term care programs. The study’s recommendations can serve as a valuable resource for policymakers and healthcare managers aiming to improve decision-making efficiency, ensure sustainable funding, and enhance the quality of life for the aging population.
Keywords : elderly, economic burden, decision-making, family involvement, nursing home, management
References:
1. Arie M. Administrative tools for regulating waiting times in healthcare systems. Healthcare Policy Journal. 2011. № 16(3). pp. 203–216.
2. Azaiza F., Brodsky J. Challenges in caregiving for the elderly in Israel. The Gerontologist. 2003. № 43(2). pp. 183–190.
3. Barry M.J., Edgman-Levitan S. Shared decision making – the pinnacle of patient-centered care. New England Journal of Medicine. 2012. № 366(9). pp. 780–781. URL: https://doi.org/10.1056/NEJMp1109283
4. Brodsky J. Aging in Israel: Policy and challenges. Journal of Aging & Social Policy. 2003. № 15(2-3), pp. 187–204. URL: https://doi.org/10.1300/J031v15n02_15
5. Brodsky J., Shnoor Y. State Health Insurance Law: An analysis of accessibility and quality. Jerusalem, 2003.
6. Centers for Disease Control and Prevention (CDC). Chronic diseases and their impact on healthcare costs. URL: https://www.cdc.gov/chronicdisease/index.htm
7. Choi S., Rhee Y., Park S. The role of education in shaping expectations and satisfaction in elderly care. Journal of Health Economics. 2020. № 29(4). pp. 223–236. URL: https://doi.org/10.1016/j.jhe.2020.05.001
8. Doctors System. Regional disparities in medical personnel availability in Israel. URL: https://www.doctorsystem.gov.il
9. Ensrud K.E. et al. Effectiveness of home and community-based services in preventing nursing home placement. Journal of the American Geriatrics Society. 2019. № 67(3). pp. 567–574. URL: https://doi.org/10.1111/jgs.15789
10. Fried L.P., et al. Frailty and the aging population: Implications for healthcare systems. The Lance. 2014. № 383(9922). pp. 1378–1387. URL: https://doi.org/10.1016/S0140-6736(13)62191-1
11. Gaugler J.E., et al. The impact of delayed medical assistance on caregiver burden. The Gerontologist. 2015. № 55(1). pp. 81–93. URL: https://doi.org/10.1093/geront/gnu119
12. Haque M.U. et al. Prolonged emergency department boarding and its impact on elderly patients. Critical Care Medicine. 2023. № 51(2). pp. 198–206. URL: https://doi.org/10.1097/CCM.0000000000005685
13. Halmas R. Population statistics and growth trends in Israel. Israel Central Bureau of Statistics Annual Report, 2024. № 2023(4). pp. 1–15.
14. Institute of Medicine (IOM) Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, 2001.
15. Jofre-Bonet M. Waiting lists and healthcare provision: The hidden costs. Health Economics. 2005. № 14(2). pp. 159–170. URL: https://doi.org/10.1002/hec.922
16. Kaiser M. et al. Consequences of delayed medical care for elderly individuals. Journal of Aging Research. 2016. URL: https://doi.org/10.1155/2016/5789542
17. Kaiser Family Foundation Delayed medical care due to cost concerns in the United States. URL: https://www.kff.org
18. Leddy K.M. et al. The economic burden of waiting for medical care. Health Policy Journal. 2003. № 63(3). pp. 247–258. URL: https://doi.org/10.1016/S0168-8510(02)00168-2
19. Levy I. Oversight challenges in health services provision in Israel. Health Policy and Management. 2007. № 9(4). pp. 133–145.
20. Mor V. et al. The impact of delayed transitions on nursing home adaptation. The Gerontologist. 2017. № 57(5), 867–876. URL: https://doi.org/10.1093/geront/gnx034
21. Morris T.A. et al. Economic implications of delayed elective hospital treatments. Health Services Research. 2023. № 58(4). pp. 789–805. URL: https://doi.org/10.1111/1475-6773.14131
22. Reinhard S.C. et al. Supporting caregivers through improved referral systems. Caregiving in the U.S., 2019 Report. Washington. DC, 2019.