The health chapter in the 2023 State of the Nation Report presents a picture of the status of health and the healthcare system in Israel on the eve of the October 7 war, including the problems and challenges facing the system and its attempts at coping with them. Researchers from the Taub Center, Professor Nadav Davidovitch, Natan Lev, and Dr. Baruch Levi, show that Israel quickly returned to the familiar pre-COVID situation characterized by low public health expenditure, while adapting to the post-crisis era — which is also the case in the reality of war — with long-term planning for optimal handling of old and new challenges ahead.
Human resources
In Israel, the ratio of physicians per capita is lower than the OECD average, although it has slightly increased over the last decade — from 3 to 3.3 doctors per 1,000 population — returning to its 2000 level.
In 2021, 2,024 new medical licenses were issued, 2.8 times the number of licenses issued in 2010. Although this is an upward trend, it is not enough, especially in light of the impact of the Yatziv Reform (which disqualifies students who trained at foreign medical schools that do not meet Israeli standards), which is expected to cause a 30% decrease in the number of students available to start medical residency from 2025. Coupled with population growth, rising needs, and the aging of the medical staff itself, the human resources crisis in the healthcare system is most likely to worsen. Researchers emphasize that, in recent years, the Ministry of Health has made significant efforts to solve or at least curb the human resources crisis in the system.
An increase was also noted in the number of licensed healthcare professionals, especially in nursing. In 2021, nearly three times as many new licenses were issued relative to 2000.
Hospital beds in acute care hospitals
In 2022, the number of acute care hospital beds in Israel (excluding psychiatric beds) was 1.77 beds per 1,000 population — a slight increase compared to 2021, when the number was 1.75 beds per 1,000 population. Although the number of beds has been on the rise over the years, relative to the population, their number is decreasing. This trend reflects the international tendency to shift the treatment focus from hospital to community care; regardless, the number of beds in Israel is still significantly lower than the OECD average (3.4 per 1,000 population in 2021). The low number of general hospital beds is particularly notable in the periphery: in the Tel Aviv and Haifa districts, the number of beds per capita is the highest, while in the Northern and Southern districts, it is the lowest.
The Ministry of Health’s development plan for hospital beds for the coming years, published at the end of December 2023, includes the addition of 1,790 acute care hospital beds, 300 rehabilitation beds, and 245 psychiatric beds. The plan was also adapted to the needs that arose following the October War, with an emphasis on mental health and rehabilitation. By 2028, with the completion of the plan’s implementation, the number of beds per 1,000 population will be about 1.77.
Health status overview
Life expectancy: In Israel, life expectancy at birth is relatively high compared to OECD countries. According to 2022 data, Israel ranks seventh with an average life expectancy of 82.9 years, and the 2023 data are expected to continue the upward trend observed with the decline of the COVID-19 pandemic.
In a breakdown by gender, women’s life expectancy is higher than men’s — 84.9 years compared to 80.9 years. By population groups, the life expectancy of Arab men is the lowest, and of Jewish women — the highest. By education level, there is a gap of over six years in favor of those with post-secondary or academic education.
Mortality rate: High mortality rates were observed mainly in low socioeconomic level localities and localities in the periphery. By population groups, high mortality rates were mainly found in Arab localities, but also in Yeruham and Dimona. In contrast, localities with low mortality rates are socioeconomically diverse and mostly located in the center of the country.
Infant mortality: In this index, Israel is in a good position: average infant mortality is low compared to the OECD average. Over the years, there has been a significant decrease in infant mortality in both the Arab and Jewish sectors, although there is still a significant gap between the sectors. In 2020, the Jewish sector had 1.6 deaths per 1,000 live births compared to 4.7 deaths in the Arab sector. There are also geographical disparities: in the Southern district, infant mortality is the highest, especially in the Arab population, and in the Central and Tel Aviv districts, the rates are the lowest.
Access to healthcare services
Monitoring data on waiting times for specialist medical services reveals that the average waiting time ranges from 31 to 83 days. Significant disparities were observed due to geographic and demographic differences and health status: the longest waiting times were reported in the Central, Tel Aviv, and Southern districts, and the shortest in the Northern district; Jews and others reported longer waiting times compared to Arabs; and chronically ill patients, who consume more consulting services compared to the general population, wait longer than generally healthy individuals. The long waiting times, as revealed by the study, are the main reason for foregoing medical treatment — 35% of insured individuals choose to forgo medical treatment for this reason. Other reasons include distance from home (19%) and the required co-payment (12%).