Gaps in accessibility to medical services - both between wealthy and poor communities and between the center of the country and the periphery - widened significantly last year, a study commissioned by the Israel Medical Association has found.

The study, whose main findings were presented at a press conference yesterday, was based on telephone interviews with a representative sample of 950 Israelis who used the public health system in 2008.

The survey found that over 10 percent of respondents, mostly the poor, had skipped medical treatment because of its cost - namely, co-payments for medicines and doctors' visits and fees charged by the health maintenance organizations. Some 13 percent did not buy medicines, 11 percent skipped a doctor's visit, 9 percent skipped medical treatment for their children and 12 percent skipped treatment for their elderly parents.

In poorer communities, however, the percentage of people who did without medical care due to its cost was higher than the national average. For instance, 17 percent skipped buying medicines (compared with 13 percent nationwide), 18 percent did without a doctor's visit (11 percent), 15 percent skipped medical treatment for their children (9 percent) and 18 percent for elderly parents (12 percent).

Moreover, these percentages were significantly higher than the previous year: The 17 percent who skipped buying medicines, for instance, compares with 13 percent in 2007.

Geography also mattered: In the north, for instance, 21 percent of respondents skipped medical care for their children (compared with 9 percent nationwide), 24 percent skipped medical care for elderly parents (12 percent) and 28 percent forwent visits to a doctor (11 percent).

Nor were these choices without consequence: Fully 49 percent of those who skipped medical care reported that their condition had worsened.

The IMA noted that to some extent, the widening gaps were due to the global economic crisis.

Nevertheless, the IMA's chairman, Dr. Yoram Blachar, warned that "it's clear that inequality in access to health services in Israel causes death and illness, including infant mortality and fatalities among diabetes patients."

He urged the government to declare that eliminating these gaps was a national priority and set up an interministerial committee to propose steps for doing so.

Ministry: IMA might have its math wrong

Despite repeated requests, the Israel Medical Association has refused to give the Health Ministry information on the methodology it used to conduct its survey, making it impossible to properly assess the results, the ministry said yesterday.

"We are familiar with other reports by the Brookdale Institute (which used a sample population three times that of this survey) that show the opposite results - that recently, the percentage of people skipping medical care and medications has decreased compared to previous years, including among weaker population groups," the ministry added.

The ministry said this reduction is due to steps it has taken including discounts on medications and other payments for needy senior citizens, and free flu and pneumonia vaccinations for certain high-risk groups. The ministry is continuing its efforts to reduce co-payments, it added.