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Smadar Atlibenkin,1 Tzvi Dwolatzky,1,2 Or Porat,1 Amir Karban,1,3,* Ronen Zalts1,3,* 1Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, 3109601, Israel; 2Geriatrics Unit, Rambam Health Care Campus, Haifa, Israel; 3Department of Internal Medicine C, Rambam Health Care Campus, Haifa, Israel*These authors contributed equally to this workCorrespondence: Ronen Zalts, Department of Internal Medicine C, Rambam Health Care Campus, Ha’Aliyah Street 8, Box 9602, Haifa, 3109601, Israel, Tel +972 4 7772321, Fax +972 4 7772260, Email r_zalts@rambam.health.gov.ilBackground: Lipid profile measurement in order to identify patients with elevated low-density lipoprotein cholesterol (LDL-C) is clearly recommended for all age groups. However, the value of screening patients for elevated LDL-C during hospitalization has not been determined. The aim of this study was to investigate the value of lipid screening tests in patients admitted to internal medicine wards, and as part of our efforts to promote a more intelligent and efficient use of laboratory and imaging tests during hospital care.Methods: We conducted this retrospective, observational study, in which medical charts of patients for whom at least one lipid profile measurement was performed during hospitalization were reviewed. The patients were categorized into 5 groups according to admission diagnosis, and for each patient, we looked if the lipid profile was mentioned or referred to, based on guidelines, in the discharge summary.Results: Lipid profile taken during hospitalization was referred to in the discharge letter in only 38.7% of patients, and even in the case of a need to consider according to guidelines, only a 45.7% consideration rate was found.Conclusion: This study highlights the need for a more efficient and focused approach to the use of lipid profile measurement during hospitalization.Keywords: lipid profile measurement, hospitalization, efficiency, discharge recommendations

A previous study conducted more than 15 years ago in Israel found a high overall use of tube-feeding for institutionalized end-stage dementia patients (52%) and a proportionally higher use (2:1) of naso-gastric tube (NG) over Percutaneous Endoscopic Gastrostomy (PEG) tubes for enteral feeding. This rate was markedly higher than that observed in other western countries (4.9-34%), and did not conform with clinical guidelines preferring spoon-feeding over tube-feeding for these patients, and PEG over NG for those in whom tube-feeding was initiated in long-term care. Over the past decade, the Israeli Ministry of Health conducted a policy reform to neutralize the administrative incentives presumed to be responsible for this situation. Further administrative and legislative developments followed suit. Despite these, we found no significant reduction in the prevalence of tube-feeding over spoon-feeding. However, we did observe a reduction in the proportional use of NG over PEG., (© 2023. The Author(s), under exclusive licence to European Geriatric Medicine Society.)

The COVID-19 pandemic has exposed the many challenges and difficulties of healthcare systems caring for older frail people. This public health crisis has indeed jeopardised the concept of the welfare state, in particular the right of older people to uncompromised healthcare. Together with the clinical challenges facing the geriatric patient and the organisational difficulties of the healthcare systems, sociocultural factors may have also played a substantial role in the strategies that countries have applied in coping with the pandemic. In this opinion article, we report attitudes towards the older populations of two countries, Italy and Israel, during the COVID-19 pandemic as viewed through the looking-glass of the media., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)