Health Care Providers and Beneficiaries 2005
West Bank and Gaza, 2005
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Reference ID
PSE-PCBS-HPBS-2005-V1.0
Producer(s)
Palestinian Central Bureau of Statistics
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Jan 28, 2020
Last modified
Jan 28, 2020
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Identification
Survey ID Number
PSE-PCBS-HPBS-2005-V1.0
Title
Health Care Providers and Beneficiaries 2005
Translated Title
مسح واقع مقدمي الخدمات الصحية 2005
Country
| Name | Country code |
|---|---|
| Palestine | PSE |
Study type
Demographic and Health Survey [hh/dhs]
Series Information
The general policy of the Palestinian Central Bureau of Statistics consists of providing regular up-to-date Palestinian formal statistics, and in making available indispensable
statistical information necessary for policy- and decision-makers. Given the lack of comprehensive up-to-date information about the current status of health expenditures in the Palestinian Territory, and the utmost need for such information for health policy and planning purposes, the Palestinian Central Bureau of Statistics conducted the Health Care Providers and Beneficiaries Survey - 2005, in close collaboration with the Palestinian Ministry of Health.
statistical information necessary for policy- and decision-makers. Given the lack of comprehensive up-to-date information about the current status of health expenditures in the Palestinian Territory, and the utmost need for such information for health policy and planning purposes, the Palestinian Central Bureau of Statistics conducted the Health Care Providers and Beneficiaries Survey - 2005, in close collaboration with the Palestinian Ministry of Health.
Abstract
The Ministry of Health (MoH) was responsible for 46.1% of all health care visits taking place in the Palestinian Territory in the year 2004. This is followed with the Private sector, which was responsible for 21.4% of all health care visits taking place during the same year. UNRWA health care institutions provided 19.7% of all health care visits and NGOs’ health care institutions came last with 12.8% of all health care visits taking place at NGOs’ health institutions. This excluded direct visits to private pharmacies and traditional medicine practitioners.
Kind of Data
Sample survey data [ssd]
Unit of Analysis
Instiutionss,Patientss
Version
Version Description
Version 1.0 dataset for public distribution
Version Date
2012-05-07
Scope
Notes
Two questionnaires are designed and implemented to fulfill the study objectives: an 'Institution Questionnaire' and a 'Patient Questionnaire'. Each of the two instruments is intended to address different target groups of stakeholders, and together fulfill the spectrum of specific objectives attached to the study. The two questionnaires are described below.
The 'Institution Questionnaire' is designed to acquire information, directly from health care providers, about their activities and performance. The questionnaire is composed of five sections: Section One collects information about the health care provider her/himself: profession and specialty, activity in terms of number of working hours and places of practice, perspective vis-à-vis administrative and technical obstacles hindering the provision of better quality care, and views with regard to potential avenues for quality improvement. Section Two collects information about the health care institution itself: type and nature of provided care, offered services and existing equipments, and available human resources. Section Three questions about institution's activity in terms of: number of working hours per day and number of working days per year, type and size of provided services, and average unit charge per service. Information from this section is intended to provide an indirect estimation of institution's expenditures/revenues, and hence, the provider's share from total national health expenditures. Section Four covers the spectrum of institutions' expenditures in nominal (monetary) terms; e.g., wages and salaries; running costs including: water, electricity, and mailing services; costs of internal and external missions; and cleaning and maintenance services. It also covers the spectrum of institutions' revenues in nominal (monetary) terms; e.g., registration fees; charges from medications; and charges from hospital stay and emergency services. Section Five is intended to estimate capital outlays. It covers all institution's capital properties and investments, including: lands, buildings and equipments.
The 'Patient Questionnaire' is divided into four sections. Section One collects information about the responding patient's socioeconomic and demographic characteristics; e.g., age, sex, education, marital status, and household income. Section Two asks about insurance coverage and insurance utilization, patient's degree of satisfaction with the current functioning of own health insurance, and whether of not she/he would prefer an alternative insurance system, and her/his willingness to pay to benefit from an optimal insurance coverage. Section Three collects information about the individual's health problem and her/his behavior in demanding health care, the spectrum of received care, and charges paid to acquire needed services. The section also asks about whether any other third-party had assisted in covering the health care costs. Finally Section Four assesses the availability and quality of needed services (from the patient's perspective), and asks about patients' satisfaction with provided care. This section also includes a group of questions for in-patients to assess their experience with in-patient services and the hospital admission process.
The 'Institution Questionnaire' is designed to acquire information, directly from health care providers, about their activities and performance. The questionnaire is composed of five sections: Section One collects information about the health care provider her/himself: profession and specialty, activity in terms of number of working hours and places of practice, perspective vis-à-vis administrative and technical obstacles hindering the provision of better quality care, and views with regard to potential avenues for quality improvement. Section Two collects information about the health care institution itself: type and nature of provided care, offered services and existing equipments, and available human resources. Section Three questions about institution's activity in terms of: number of working hours per day and number of working days per year, type and size of provided services, and average unit charge per service. Information from this section is intended to provide an indirect estimation of institution's expenditures/revenues, and hence, the provider's share from total national health expenditures. Section Four covers the spectrum of institutions' expenditures in nominal (monetary) terms; e.g., wages and salaries; running costs including: water, electricity, and mailing services; costs of internal and external missions; and cleaning and maintenance services. It also covers the spectrum of institutions' revenues in nominal (monetary) terms; e.g., registration fees; charges from medications; and charges from hospital stay and emergency services. Section Five is intended to estimate capital outlays. It covers all institution's capital properties and investments, including: lands, buildings and equipments.
The 'Patient Questionnaire' is divided into four sections. Section One collects information about the responding patient's socioeconomic and demographic characteristics; e.g., age, sex, education, marital status, and household income. Section Two asks about insurance coverage and insurance utilization, patient's degree of satisfaction with the current functioning of own health insurance, and whether of not she/he would prefer an alternative insurance system, and her/his willingness to pay to benefit from an optimal insurance coverage. Section Three collects information about the individual's health problem and her/his behavior in demanding health care, the spectrum of received care, and charges paid to acquire needed services. The section also asks about whether any other third-party had assisted in covering the health care costs. Finally Section Four assesses the availability and quality of needed services (from the patient's perspective), and asks about patients' satisfaction with provided care. This section also includes a group of questions for in-patients to assess their experience with in-patient services and the hospital admission process.
Topics
Keywords
| Keyword | Vocabulary | URI |
|---|---|---|
| Health services | Glossary statistical | Link |
Coverage
Geographic Coverage
All health care institutions regularly functioning in the Palestinian Territory at the time of study
Universe
Patients in govermental healthy Instiutionss، and the govermental healthy Instiutionss
Producers and sponsors
Primary investigators
| Name | Affiliation |
|---|---|
| Palestinian Central Bureau of Statistics | Palestinian National Authority |
Producers
| Name |
|---|
| The Ministry of Health |
Funding Agency/Sponsor
| Name | Abbreviation | Role |
|---|---|---|
| The Palestinian National Authority | PNA | Financial assistance |
| The Core Funding Group | CFG | Financial assistance |
| The Italian Cooperation | IC | Financial assistance |
| World Bank | WB | Financial assistance |
Other Identifications/Acknowledgments
| Name | Affiliation | Role |
|---|---|---|
| The Core Funding Group represented by the representative office | CFG | responded to the survey instrument |
| The Italian Cooperation | IC | responded to the survey instrument |
Sampling
Sampling Procedure
Private and NGOs health institutions covered in the present study are selected from a complete list of health institutions obtained from the “Establishment Census” conducted by
PCBS in the year 2004. The total number of health institutions belonging to the Private and NGO sectors amounted to 3,545 institutions of all types. Sampled patients from the Private and NGOs sector were chosen from the entire population of patients frequenting the sampled institutions. On the other hand, patients selected from MoH and UNRWA health institutions were amongst those frequenting health facilities belonging to MoH and UNRWA, and situated geographically close to the sampled Private and NGOs health institutions.
Sample Size
Of the entire population of Private and NGOs health institutions, 1,202 institutions are sampled to study the Private and NGOs sectors. Selected institutions are either: generalists’ or specialists’ medical clinics, medical laboratories, physiotherapy/rehabilitation centers, dental clinics or hospitals, distributed over all the governorates of the West Bank and Gaza Strip. All hospitals belonging to the Private and NGOs sectors were included in the study sample. The total number of interviewed patients amounted to 3,265 patients, sampled from the population of patients of most of the selected health institutions, and present at the institution site at the time of administering the institution questionnaire – this was the case for
Private and NGOs health institutions. The patient sample was then enlarged with a subsample of patients frequenting nearby health facilities belonging to the MoH and UNRWA
health sectors.
Sample Design
The study sample is obtained following a Single-Stage Stratified Random Sampling approach, whereby the health institution represents the Primary Sampling Unit (PSU). In order to enhance the efficiency and representativness of the study sample, four strata are specified, and institutions are sampled based on the following sequence:
Geographical level: health institutions are divided into three geographical regions: the West Bank and Jerusalem inside Israeli checkpoints, ( that part of Jerusalem, which annexed by Israel After the 1967 war) and Gaza Strip.
Human workforce: here, health institutions are classified according to their number of employees.
In addition to two implicit strata: the governorate and economic activity (up to the fourth
classification level), in order better represent governorates and economic activities.
PCBS in the year 2004. The total number of health institutions belonging to the Private and NGO sectors amounted to 3,545 institutions of all types. Sampled patients from the Private and NGOs sector were chosen from the entire population of patients frequenting the sampled institutions. On the other hand, patients selected from MoH and UNRWA health institutions were amongst those frequenting health facilities belonging to MoH and UNRWA, and situated geographically close to the sampled Private and NGOs health institutions.
Sample Size
Of the entire population of Private and NGOs health institutions, 1,202 institutions are sampled to study the Private and NGOs sectors. Selected institutions are either: generalists’ or specialists’ medical clinics, medical laboratories, physiotherapy/rehabilitation centers, dental clinics or hospitals, distributed over all the governorates of the West Bank and Gaza Strip. All hospitals belonging to the Private and NGOs sectors were included in the study sample. The total number of interviewed patients amounted to 3,265 patients, sampled from the population of patients of most of the selected health institutions, and present at the institution site at the time of administering the institution questionnaire – this was the case for
Private and NGOs health institutions. The patient sample was then enlarged with a subsample of patients frequenting nearby health facilities belonging to the MoH and UNRWA
health sectors.
Sample Design
The study sample is obtained following a Single-Stage Stratified Random Sampling approach, whereby the health institution represents the Primary Sampling Unit (PSU). In order to enhance the efficiency and representativness of the study sample, four strata are specified, and institutions are sampled based on the following sequence:
Geographical level: health institutions are divided into three geographical regions: the West Bank and Jerusalem inside Israeli checkpoints, ( that part of Jerusalem, which annexed by Israel After the 1967 war) and Gaza Strip.
Human workforce: here, health institutions are classified according to their number of employees.
In addition to two implicit strata: the governorate and economic activity (up to the fourth
classification level), in order better represent governorates and economic activities.
Response Rate
The response rate for the Patient Questionnaire. Patients were recruited from 81.0% of the sampled institutions
Out of all institutions included in the sample, 81.6% reported enough information for analysis.
Out of all institutions included in the sample, 81.6% reported enough information for analysis.
Weighting
A weight is defined as the inverse of the probability of selecting a subject from the study population, to be included in the study sample. It is interpreted as the number of subjects in the population that are represented by a particular subject in the sample. In the present study, weights are estimated taking into account institutions’ sizes and types as depicted by the “Establishment Census” of the year 2004. Estimated weights are then adjusted to account for
non-respondents and uncompleted questionnaires during the fieldwork. Indeed, adjustments of a priori estimated weights remain an important step to avoid any potential bias due to nonrespondents and to account for changes in the number of institutions in the post census period.
On the other hand, results from the Patient Questionnaire are presented un-weighted. This is basically due to the manner whereby the patient sample was recruited, and the absence of a reliable framework that specifies the characteristics of the population of patients in the country. For further analysis one could use one of two alternative methods to create weights
for the patients file – each has its own shortcomings. One of the methods consists in relying on the characteristics of the sub-sample of patients from the previous Household Health Expenditure Survey-2004, where patients were recruited at the level of their households and their characteristics and behavior in demanding health care were directly identified. These
weights were used to publish the Preliminary Results of the present survey. The second approach would make use of the number of patients frequenting the different types of health institutions, as stated by the providers in the Institution Questionnaire. The problem with the second approach is that adjustment would not take into account the socioeconomic and demographic characteristics of the population of patients, and more importantly the Institution weights that would be needed to estimate the patients’ weights were not designed to take into account the number of patients frequenting the population of institutions in the sampling frame.
non-respondents and uncompleted questionnaires during the fieldwork. Indeed, adjustments of a priori estimated weights remain an important step to avoid any potential bias due to nonrespondents and to account for changes in the number of institutions in the post census period.
On the other hand, results from the Patient Questionnaire are presented un-weighted. This is basically due to the manner whereby the patient sample was recruited, and the absence of a reliable framework that specifies the characteristics of the population of patients in the country. For further analysis one could use one of two alternative methods to create weights
for the patients file – each has its own shortcomings. One of the methods consists in relying on the characteristics of the sub-sample of patients from the previous Household Health Expenditure Survey-2004, where patients were recruited at the level of their households and their characteristics and behavior in demanding health care were directly identified. These
weights were used to publish the Preliminary Results of the present survey. The second approach would make use of the number of patients frequenting the different types of health institutions, as stated by the providers in the Institution Questionnaire. The problem with the second approach is that adjustment would not take into account the socioeconomic and demographic characteristics of the population of patients, and more importantly the Institution weights that would be needed to estimate the patients’ weights were not designed to take into account the number of patients frequenting the population of institutions in the sampling frame.
Data Collection
Dates of Data Collection
| Start | End |
|---|---|
| 2005-11-26 | 2005-12-31 |
Time periods
| Start date | End date |
|---|---|
| 2004-01-01 | 2004-12-31 |
Data Collection Mode
Face-to-face [f2f]
Supervision
Special patterns were designed to follow-up receiving and handing in questionnaires at all levels and the daily follow up of interviewers work. The supervisor handed out work on the team using a map and sample. Daily and weekly reports were submitted to the coordinator of the fieldwork and the project administration. The reports explain the number of complete interviews and non-response. In addition to conducting field visits by the technicians and coordinators in order to oversee work and ensure data quality and assisting in solving any problems facing the field team.
Data Collection Notes
The main fieldwork in the West Bank and Gaza Strip started on November 26, 2005 and was completed on December 30, 2005. 17 mobile teams in the West Bank and Gaza Strip performed the entire fieldwork. Each of the teams was composed of 3-5 fieldworkers, one supervisor, one assistant and one field editor. The work team implemented several field editing exercises, which included further spot-checks if needed. The field editor thoroughly checked and corrected any obvious mistakes and slips.
Data Collectors
| Name | Abbreviation | Affiliation |
|---|---|---|
| Palestinian Central Bureau of Statistics | PCBS | Palestinian National Authority |
Questionnaires
Questionnaires
Two questionnaires are designed and implemented to fulfill the study objectives: an 'Institution Questionnaire' and a 'Patient Questionnaire'. Each of the two instruments is intended to address different target groups of stakeholders, and together fulfill the spectrum of specific objectives attached to the study. The two questionnaires are described below.
The 'Institution Questionnaire' is designed to acquire information, directly from health care providers, about their activities and performance. The questionnaire is composed of five sections: Section One collects information about the health care provider her/himself: profession and specialty, activity in terms of number of working hours and places of practice, perspective vis-à-vis administrative and technical obstacles hindering the provision of better quality care, and views with regard to potential avenues for quality improvement. Section Two collects information about the health care institution itself: type and nature of provided care, offered services and existing equipments, and available human resources. Section Three questions about institution's activity in terms of: number of working hours per day and number of working days per year, type and size of provided services, and average unit charge per service. Information from this section is intended to provide an indirect estimation of institution's expenditures/revenues, and hence, the provider's share from total national health expenditures. Section Four covers the spectrum of institutions' expenditures in nominal (monetary) terms; e.g., wages and salaries; running costs including: water, electricity, and mailing services; costs of internal and external missions; and cleaning and maintenance services. It also covers the spectrum of institutions' revenues in nominal (monetary) terms; e.g., registration fees; charges from medications; and charges from hospital stay and emergency services. Section Five is intended to estimate capital outlays. It covers all institution's capital properties and investments, including: lands, buildings and equipments.
The 'Patient Questionnaire' is divided into four sections. Section One collects information about the responding patient's socioeconomic and demographic characteristics; e.g., age, sex, education, marital status, and household income. Section Two asks about insurance coverage and insurance utilization, patient's degree of satisfaction with the current functioning of own health insurance, and whether of not she/he would prefer an alternative insurance system, and her/his willingness to pay to benefit from an optimal insurance coverage. Section Three collects information about the individual's health problem and her/his behavior in demanding health care, the spectrum of received care, and charges paid to acquire needed services. The section also asks about whether any other third-party had assisted in covering the health care costs. Finally Section Four assesses the availability and quality of needed services (from the patient's perspective), and asks about patients' satisfaction with provided care. This section also includes a group of questions for in-patients to assess their experience with in-patient services and the hospital admission process.
The 'Institution Questionnaire' is designed to acquire information, directly from health care providers, about their activities and performance. The questionnaire is composed of five sections: Section One collects information about the health care provider her/himself: profession and specialty, activity in terms of number of working hours and places of practice, perspective vis-à-vis administrative and technical obstacles hindering the provision of better quality care, and views with regard to potential avenues for quality improvement. Section Two collects information about the health care institution itself: type and nature of provided care, offered services and existing equipments, and available human resources. Section Three questions about institution's activity in terms of: number of working hours per day and number of working days per year, type and size of provided services, and average unit charge per service. Information from this section is intended to provide an indirect estimation of institution's expenditures/revenues, and hence, the provider's share from total national health expenditures. Section Four covers the spectrum of institutions' expenditures in nominal (monetary) terms; e.g., wages and salaries; running costs including: water, electricity, and mailing services; costs of internal and external missions; and cleaning and maintenance services. It also covers the spectrum of institutions' revenues in nominal (monetary) terms; e.g., registration fees; charges from medications; and charges from hospital stay and emergency services. Section Five is intended to estimate capital outlays. It covers all institution's capital properties and investments, including: lands, buildings and equipments.
The 'Patient Questionnaire' is divided into four sections. Section One collects information about the responding patient's socioeconomic and demographic characteristics; e.g., age, sex, education, marital status, and household income. Section Two asks about insurance coverage and insurance utilization, patient's degree of satisfaction with the current functioning of own health insurance, and whether of not she/he would prefer an alternative insurance system, and her/his willingness to pay to benefit from an optimal insurance coverage. Section Three collects information about the individual's health problem and her/his behavior in demanding health care, the spectrum of received care, and charges paid to acquire needed services. The section also asks about whether any other third-party had assisted in covering the health care costs. Finally Section Four assesses the availability and quality of needed services (from the patient's perspective), and asks about patients' satisfaction with provided care. This section also includes a group of questions for in-patients to assess their experience with in-patient services and the hospital admission process.
Data Processing
Data Editing
Collected data was entered using ACCESS package for Windows. The data entry was organized in a number of files to correspond to the main parts of the questionnaire. A data entry template was designed to reflect the exact image of the questionnaire, and to include various electronic checks: logical check, consistency checks and cross-validation. Continuously thorough checks were held on the overall consistency of the data files, and some questionnaires were sent back to the field for corrections, when needed. Data entry started in December 3, 2005 and finished in January 10, 2006. Data cleaning and checking processes were initiated simultaneously with data entry. Thorough data quality checks and consistency checks were carried out.
Final tabulation of survey results was performed using the statistical package SPSS for Windows (version 12.0).
Final tabulation of survey results was performed using the statistical package SPSS for Windows (version 12.0).
Data Appraisal
Estimates of Sampling Error
Since the data reported here are based on a sample survey, and not on complete enumeration, they are subjected to two main types of errors: sampling errors and non-sampling errors. Sampling errors are random outcomes emerging from the sample design, and are, therefore, measurable. However, non-sampling errors can occur at the various stages of the survey implementation, data collection and data processing, and are generally difficult to be evaluated statistically. They cover a wide range of errors, including errors resulting from non-response, sample frame coverage, data processing and response bias (both respondent- and interviewer-related). The use of effective training and supervisions and the careful design of questions have direct bearing on the magnitude of non-sampling errors, and hence the quality of the resulting data.
Fieldwork procedures were designed and organized to ensure effective supervision and high quality data. To this end, several quality control measures were implemented. These included: periodic sudden visits by project technical team to the fieldworkers; organization of a full-day meeting to re-call study objectives and discuss in-field problem solving; continuous communication between the central office staff and the field in the form of daily and weekly reporting; re-interviewing by phone of about 10% of the institutions included in the sample by supervisors; observation of interviewers by supervisors; distribution of written memos to the field when confusion arises; precise documentation of the flow of the questionnaires through a control sheet; and limiting call backs to three visits per institution
Fieldwork procedures were designed and organized to ensure effective supervision and high quality data. To this end, several quality control measures were implemented. These included: periodic sudden visits by project technical team to the fieldworkers; organization of a full-day meeting to re-call study objectives and discuss in-field problem solving; continuous communication between the central office staff and the field in the form of daily and weekly reporting; re-interviewing by phone of about 10% of the institutions included in the sample by supervisors; observation of interviewers by supervisors; distribution of written memos to the field when confusion arises; precise documentation of the flow of the questionnaires through a control sheet; and limiting call backs to three visits per institution
Access policy
Contacts
| Name | Affiliation | URL | |
|---|---|---|---|
| Division of Users Services | Palestinian Central Bureau of Statistics | diwan@pcbs.gov.ps | www.pcbs.gov.ps |
Confidentiality
General Statistics Law
No. (5) for Year 2000
Article (17
1. All individual information and data submitted to the Bureau for statistical purposes shall be treated as confidential and shall not be divulged, in whole or in part, to any individual or to a public or private body, or used for any purpose other than for preparing statistical tables.
2. The Bureau shall endeavor to issue official statistical publications in aggregate tables, which do not disclose individual data, in conformity with the confidentiality of statistical data.
Access conditions
License Agreement for the Use of Micro Data in PCBS
items(10,11,12) as following:
1. pledges the utilization of "data" or any copies thereof shall be limited to the purposes agreed upon including not granting any third parties any access to these data. Restrictions applies to any data duplication or transformed setting for purposes other than meeting the requirements of the statistical programs used in data analysis.
2. Utilization of "data" or any copies thereof is limited to personal computers normally .
3. pledges not to alter the value of any observation in the original "data"; nevertheless, this does not apply on subjecting data to any processes or procedures aiming to derive new variables. The first party does not bear any professional, administrative or financial responsibility for any losses incurred as a result of changes in the variables values
items(10,11,12) as following:
1. pledges the utilization of "data" or any copies thereof shall be limited to the purposes agreed upon including not granting any third parties any access to these data. Restrictions applies to any data duplication or transformed setting for purposes other than meeting the requirements of the statistical programs used in data analysis.
2. Utilization of "data" or any copies thereof is limited to personal computers normally .
3. pledges not to alter the value of any observation in the original "data"; nevertheless, this does not apply on subjecting data to any processes or procedures aiming to derive new variables. The first party does not bear any professional, administrative or financial responsibility for any losses incurred as a result of changes in the variables values
Citation requirements
Palestinian Central Bureau of Statistics.Health Care Providers and Beneficiaries 2005. V 1.0 05-2012 . Ramallah - Palestine.
Access authority
| Name | Affiliation | URL | |
|---|---|---|---|
| Palestinian Central Bureau of Statistics | Palestinian National Authority | Diwan@pcbs.gov.ps | www.pcbs.gov.ps |
Disclaimer and copyrights
Disclaimer
The user of the data acknowledges that the original collector of the data, the authorized distributor of the data, and the relevant funding agency bear no responsibility for use of the data or for interpretations or inferences based upon such uses.
Copyright
© All Rights Reserved.Palestinian Central Bureau of Statistics, Health Care Providers and Beneficiaries 2005
Metadata production
DDI Document ID
DDI-PSE-PCBS-HPBS-2005-V1.0
Producers
| Name | Abbreviation | Affiliation | Role |
|---|---|---|---|
| Palestinian Central Bureau of Statistics | PCBS | Palestinian Nationa Authority | Production and execute the survey |
Date of Metadata Production
2012-05-07
DDI Document version
Version 1.0 MAY / 2012