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Comprehensive Primary Care at the Neighborhood Level: An Israeli Experiment That Failed

This paper is an analysis of the first stage of a demonstration program designed to integrate within neighborhood clinics various health and welfare services that were previously provided separately. The program included the active participation of quasi-public, governmental, private, philanthropic, and university institutions. The purpose here is to understand the failure to achieve the original goals and purposes. The analysis takes an organizational perspective, and should contribute to a better understanding of why programs designed to change existing service-delivery systems are inclined to fail. Although this is a case-study of a demonstration program in Israel, the findings should have relevance and interest for academicians and professionals in other countries.