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Monitoring of Economic Processes in Health Care

2011
Department: Laboratory of Economic Problems in Health Care
The project has been carried out as part of the HSE Program of Fundamental Studies.

The study is devoted to the analysis of the economic aspects of the health care subject activities. 

The objective of the study is to monitor, on a systematic basis, economic developments in the Russian health care system. The study explores changes in the access of medical services to the population, economic conditions of medical care provision, economic conditions for health facility operation, employment conditions in health care system, etc. The study is carried out annually, changing the focus of the study either by including additional subjects of the health care system or by changing the investigated aspects of economic developments.

The empirical basis of 2011 study comprises the following surveys:
-RLMS, health care section,
-“Georeiting”, specially included additional questions on medical care consumption and payment,
-Survey of private medical facility managers.

The data obtained from the analysis shows considerable variations in the physical and economic accessibility of medical services among different social and economic groups of population, as well as considerable regional variations.  The study demonstrates that regions with higher level of economic development are capable of creating a fairer health care financing system, providing greater economic protection of population when needed to bear expenses due to ill health and the increasing economic accessibility of hospital care.
The indicators of medical care access provide evidence of the increasing necessity of reforming state guarantees in the health care system aimed at providing equal access to medical care for different social and economic groups of population as well as to improve system of regional equalization, to increase the efficiency of mechanisms and tools to secure state guarantees. 

The analysis of the private medical provider system shows that a private market has been formed in Russia, which is able, to a certain extent, to compete with the state system when taking into account the growth of formal and informal payments in the state system and the identity of services provided in both systems. At the same time, in the most cases, the private sector develops out of the state system bounds. In accordance with opinion of private medical providers the main obstacles for future development of private sector are bureaucratic hurdles and the legal purchasing power of the population. The future development of the private provider sector and its role in health care system will be predicated upon state policy in the development of health insurance. The development of the private provider sector could become an essential factor for the increasing accessibility of qualitative medical care for a sizable part of population under the condition of providing active state policy aimed at including private providers in compulsory health insurance and promoting voluntary health insurance.

The results of the 2011 study were used to develop the National strategy of social and economic development till 2020, working group on health and human environment.