Reducing infantile anemia: insight on patterns of process and outcome indicators by ethnicity and socioeconomic class during a 10-year intervention program and 5 years after

Israel Journal of Health Policy Research

Michael Sherf¹  Doron Comaneshter¹  Shraga Aviner²  Arnon D. Cohen³  Joseph Meyerovitch⁴  Calanit Key⁵  Yoseph Laks⁶  Uri Gabbay⁷  Doron Carmi⁸ 

[1] Clalit Health Services, Tel Aviv, Israel;Department of Pediatrics, Faculty of Health Sciences, Barzilai University Medical Center, Ashkelon, Israel;Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel;Department of Pediatrics, Faculty of Health Sciences, Barzilai University Medical Center, Ashkelon, Israel;Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel;Siaal Research Center for Family Medicine and Primary Care Faculty of Health Sciences, Ben Gurion University of Negev, Beer Sheva, Israel;Medicine Wing, Community Division, Clalit Health Services, Tel Aviv, Israel;The Jesse Z and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children’s Medical Center of Israel, Petach Tikva, Israel;Sackler Faculty of Medicine, Tel Aviv University, 6997801, Ramat Aviv, Tel-Aviv, Israel;Nursing Medicine Wing, Community Division, Clalit Health Services, Tel Aviv, Israel;Pediatric Ambulatory Center, Clalit Health Services, Tel Aviv, Israel;Sackler Faculty of Medicine, Tel Aviv University, 6997801, Ramat Aviv, Tel-Aviv, Israel;Quality Unit, Rabin Medical Center, Petach Tikva, Israel;Shoham Ambulatory Center, Clalit Health Services, Shoham, Israel;

关键词: Infantile anemia (IA);    Intervention program;    Process;    Outcome;    Yield;   

DOI  :  10.1186/s13584-021-00510-9

来源: Springer

【 摘 要 】

BackgroundIn 2005, Clalit Health Services (CHS), the largest health maintenance organization in Israel, initiated an intervention program aimed at reducing the prevalence rate of infantile anemia (IA). This study evaluated the progress made during the intervention (2005–2014) and its yield 5 years after it ended (2019).MethodsThe CHS database was retrospectively reviewed twice yearly from 2005 to 2014 for repetitive samples of children aged 9 to 18 months regarding the previous half-year interval, and a single sample in 2019. Data were collected on gender, ethnicity (Jewish/non-Jewish), socioeconomic class (SEC; low/intermediate/high), hemoglobin testing (yes/no), and hemoglobin level (if tested). Excluded were infants with documented or suspected hemoglobinopathy.ResultsAt study initiation, the rate of performance of hemoglobin testing was 54.7%, and the IA prevalence rate was 7.8%. The performance rate was lower in the Jewish than the non-Jewish subpopulation. The low-SEC subpopulation had a similar hemoglobin testing rate to the high-SEC subpopulation but double the IA prevalence rate. Overall, by the end of the intervention (2014), the performance rate increased to 87.5%, and the AI prevalence rate decreased to 3.4%. In 2019, there was little change in the performance rate from the end of the intervention (88%) and the IA prevalence was further reduced to 2.7%. The non-Jewish and low-SEC subpopulations showed the most improvement which was maintained and even bettered 5 years after the intervention ended.ConclusionsThe 10-year IA intervention program introduced by CHS in 2005 led to a reduction in IA prevalence rate to about 3.5% in all sub-populations evaluated. By program end, the results in the weaker subpopulations, which had the highest prevalence of IA at baseline, were not inferior to those in the stronger subpopulations. We recommended to the Israel Ministry of Health to adopt the intervention countrywide, and we challenge other countries to consider similar interventions.

【 授权许可】

CC BY