A Model of Chronic Disease Management: Israeli Physicians' Approach to Cardiovascular Risk Factor Management

The prevalence of cardiovascular disease (CVD) death in Israel, a high-income country that provides universal healthcare, is ~25 percent lower than in the United States. Is better disease management a factor? Primary care physicians answered a web-based survey asking how they manage patients with CVD risk factors and about the health-care system at the macro level. Most physicians (53.6 percent) spent 5–10 minutes managing CVD risks; 39.3 percent spent 10–20 minutes. Over 40 percent of physicians scheduled return visits in less than 3 months. Their emphasis was on either balanced lifestyle and medication management or lifestyle (91 percent), while only 9 percent emphasized medication management. They believe that universal coverage and the motivation of both the doctor and patient are key in the successful outcomes. Israeli physicians provide resource-intensive disease management, committing time, providing frequently repeated visits, and focusing on a balance of lifestyle and medication management. These practices may provide good chronic disease management and could contribute to reduced cardiovascular death.