Russian healthcare: problems and solutions
AbstractThe article describes common misconceptions about the health care system of the Russian Federation – on its non significant influence on mortality of the population; that it’s possible to extrapolate the data on medical personnel and hospital beds availability from developed countries to the Russian healthcare system directly; as well as the fact that primary care doctors can take any additional workload (for example on patient monitoring at their homes, prevention and other care). The authors prove the conclusion, that situation in Russia with mortality increase is becoming serious, so immediate interventions in healthcare system are necessary. To improve the situation «budget and managerial maneuver» is proposed. The essence of this maneuver – redirection of the expenditures from non-priority and inefficient health spending, and additional Federal budget resources, to solve the main problem – medical personnel evolution. Two scenarios (plans) of Russian healthcare strategic development are given: survival and basic.
It is shown, that for the conservation of total mortality at the level of 2013 (13.1 cases per 1000 population) the public healthcare financing should also remain at the 2013 level – it’s the scenario survival. The basic scenario provides step-by-step to the year 2020 public healthcare expenditures growth from 3.7 to 5.2% of GDP (or 1.4 times more than in 2013). This will allow to reduce the mortality rate to 11.8 cases per 1000 population, so to achieve the target value of life expectancy – 74 years. The article also describes the consequences of not taking any actions to increase public healthcare expenditures.
Keywords:healthcare system in Russia, demographic indicators of the Russian Federation, healthcare system objectives, public health expenditures, strategies of the healthcare system development