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2 . 2021

Implications of reforms in Russian healthcare from 1990-2020. Problems and proposals


The aim is to analyze the main consequences of the reform of the national health care and to consider measures that would contribute to improving the organization of medical care to the population.

Material and methods. We used statistical data from the Ministry of Health of the Russian Federation, Rosstat, Federal Research Institute for Health Organization and Informatics, as well as data for the Siberian Federal District. Scientific publications on the problem under consideration have been studied.

Results. The measures taken in the country to improve the organization of medical care to the population are not effective enough, and sometimes untenable and aggravate the already difficult situation in the industry. The article presents some results of the implementation of state concepts, projects and programs that did not provide a reduction in the overall mortality of the population, including among people of working age, and an increase in the life expectancy to the planned level.

This was the result of insufficient scientific justification of the planned results and the lack of responsibility on the part of officials who did not ensure their implementation, including the implementation of the President's instructions to increase the salaries of medical workers. Special attention is paid to the activities of the industry within the framework of compulsory health insurance, as well as to the state of rural health care, which has deteriorated significantly in recent years. The authors consider a minimum of measures to preserve the public health sector, to ensure its more effective functioning and to increase the availability and quality of medical care to the population on this basis.

Conclusion. The health care reform carried out over the past three decades has not yielded the planned results, and in some areas has led to a deterioration of the situation due to insufficient scientific justification of the measures taken. The vast majority of doctors and the population believe that we should abandon compulsory health insurance and suspend the optimization of the industry. It is necessary to take measures, the implementation of which will preserve the public health sector and improve its functioning.

Keywords:health care organization, medical care, reform, remuneration, personnel, financing, medical organizations.

Funding. The study had no sponsor support.

Conflict of interest. The authors declare no conflict of interest.

Contribution. Analysis of personnel issues in health care, the effects of reforming the industry, demographics and public health, writing text, editing the article, making the necessary edits - Chernyshev V.M.; analysis of the issues of the economy of health and remuneration - Strelchenko O.V.; collection and processing of statistical information - Mingazov I.F.

For citation: Chernyshev V.M., Strelchenko O.V., Mingazov I.F. Implications of reforms in Russian healthcare from 1990-2020. Problems and proposals. ORGZDRAV: novosti, mneniya, obuchenie. Vestnik VSHOUZ [HEALTHCARE MANAGEMENT: News, Views, Education. Bulletin of VSHOUZ]. 2021; 7 (2): 86-102. DOI: (in Russian)


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Guzel E. Ulumbekova
MD, MBA from Harvard University (Boston, USA), Head of the Graduate School of Healthcare Organization and Management (VSHOUZ), Associate Professor of the Department of Public Health and Health Care, Health Economics, Faculty of Pediatric of the Pirogov Russian National Research Medical University
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