Russian Federation: health system review
提要
The HiT reviews are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. At independence from the Soviet Union in 1991, the Russian health system inherited an extensive, centralized Semashko system, but was quick to reform health financing by adopting a mandatory health insurance (MHI) model in 1993. While the health system has evolved significantly since the early 1990s, the legacy of a highly centralized system focused on universal access to basic care remains. High energy prices on world markets have ensured greater macroeconomic stability, a budget surplus and improvements in living standards for most of the Russian population. However, there is a marked urban–rural split and rural populations have worse health and poorer access to health services than urban populations. Provider payment mechanisms are the main obstacle to improving technical efficiency in the Russian health system, as most budget funding channelled through local government is input based. The most recent reforms as well as legislation in the pipeline seek to ensure all health care funding is channelled through a strengthened MHI system with contracts for provider payments being made using output-based measures.引用
World Health Organization. Regional Office for Europe, European Observatory on Health Systems and Policies, Popovich, Larisa, Potapchik, Elena, Shishkin, Sergey. et al. (2011). Russian Federation: health system review. World Health Organization. Regional Office for Europe. https://iris.who.int/handle/10665/330324
关系
Health Systems in Transition, vol. 13 (7)