Current practice of organizing and financing the departmental healthcare system for the military in developed countries: a review
Abstract
Departmental medicine as a Russian-specific healthcare system is currently subject to broad discussions on whether its further support and financing is worthwhile. The Defense Ministry of the Russian Federation has one of the most developed healthcare systems in Russia and thus provides medical care to the military personnel and the veterans. This report aims to review the current practice of organizing and financing the medical assistance for the military in seven developed countries (USA, Uk, Canada, Germany, France, Finland and Singapore) in order to use their experience for the optimization of the Russian military departmental healthcare. This review covers the general principles of healthcare in these countries as well as the specific mechanisms of health care provision for the military. The Departments of Defense in the reviewed counties have special agencies that provide medical services to the military personnel. The primary role of such agencies is to promote, protect and restore the health of servicemen and servicewomen and to ensure they are ready and fit to perform their missions. As shown in the present review, the specific details of the medical assistance to the military differ between the countries and largely depend on the overall structure of the national healthcare system.
About the Authors
T. P. Bezdenezhnykh
Center for Healthcare Quality Assessment and Control of the Ministry of Health of the Russian Federation.
Russian Federation
Bezdenezhnykh Tatiana Pavlovna – Leading Specialist. 10-5 Khokhlovskii pereulok , Moscow 109028.
Russian Federation
Bezdenezhnykh Tatiana Pavlovna – Leading Specialist. 10-5 Khokhlovskii pereulok , Moscow 109028.
D. V. Lukyantseva
Center for Healthcare Quality Assessment and Control of the Ministry of Health of the Russian Federation; Research Financial Institution of the Ministry of Finance of the Russian Federation, Federal State Budget Institution.
Russian Federation
Russian Federation
MD, PhD, Leading Research Fellow at the Center of Healthcare Financing, Financial Research Institute, Ministry of Finance of the Russian Federation, Chief Specialist, Center for Healthcare Quality Assessment and Control.
10-5 Khokhlovskii pereulok , Moscow 109028; 3-2 Nastasyinsky pereulok, Moscow 127006.
References
1. Miroshnichenko Yu.V., Tihonov A.V., Golubenko R. A. FARMAkOekOnOMikA. Sovremennaya farmakoekonomika i farmakoepidemiologiya / FARMAkOekOnOMikA. Modern pharmacoecono-mics and pharmacoepidemiology (in Russian). 2012; 5 (4): 31-34.
2. Miroshnichenko Yu.V., Gaynov V. S. FARMAkOekOnOMikA. Sovremennaya farmakoekonomika i farmakoepidemiologiya / FARMAkOekOnOMikA. Modern pharmacoeconomics and pharmacoepidemiology (in Russian). 2012; 5 (2): 24-26.
3. Omel’yanovskiy V.V., Maksimova L.V., Tatarinov A.P. FARMAkOekOnOMikA. Sovremennaya farmakoekonomika i farmakoepidemiologiya / FARMAkOekOnOMikA. Modern pharmacoeconomics and pharmacoepidemiology (in Russian). 2014; 7 (2): 51-56.
4. Dayhes A. N., Fedyaev D. V. FARMAkOekOnOMikA. Sovremennaya farmakoekonomika i farmakoepidemiologiya / FARMAkOekOnOMikA. Modern pharmacoeconomics and pharmacoepidemiology (in Russian). 2017; 10 (3): 59-65.
5. Health expenditure and financing. OECDStat. [electronic resource] URL: http://stats.oecd.org/Index.aspx?DataSetCode=SHA. Accessed: 27.03.2018.
6. Center for Medicare and Medicaid services: National Health Expenditure Data. [electronic resource] URL: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData. Accessed: 27.03.2018
7. Center for Medicare and Medicaid services: National Health Expenditure 2016 Highlights. [electronic resource] URL: https://www.cms.gov/ResearchStatistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/Downloads/highlights.pdf. Accessed: 27.03.2018.
8. Wilensky G. R. et al. Future of Military Health Care Final Report. – Defense Health Agency/Defense Health Board Falls Church United States, 2007.
9. TRICARE Select Costs. [electronic resource] URL: https://www.tricare.mil/Costs/HealthPlanCosts/TS. Accessed: 27.03.2018.
10. Veterans Health Administration: Health. [electronic resource] URL: https://www.va.gov/health/. Accessed: 27.03.2018.
11. Veterans Health Administration: Veterans Eligibility. [electronic resource] URL: https://www.va.gov/HEALTHBENEFITS/apply/veterans.asp. Accessed: 27.03.2018.
12. George Stoye. UK health spending – IFS. The Institute for Fiscal Studies. 2017. [electronic resource] URL: https://www.ifs.org.uk/uploads/publications/bns/BN201.pdf. Accessed: 27.03.2018.
13. Davis K. et al. Mirror, mirror on the wall, 2014 update: how the US health care system compares internationally. The Commonwealth Fund. 2014; 16: 1-31. [electronic resource] URL: http://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror. Accessed: 27.03.2018.
14. NHS: Armed Forces Healthcare: How it works. [electronic resource] URL: https://www.nhs.uk/NHSEngland/Militaryhealthcare/serving/Pages/about-armed-forces-healthcare.aspx. Accessed: 27.03.2018.
15. Colonel Katherine Richardson. Defense Health Board: THE UK MILITARY HEALTH SYSTEM: A SYSTEM BUILT ON COLLABORATION. [electronic resource] URL https://health.mil/Reference-Center/Presentations?query=&page=16#pagingAnchor. Accessed: 13.04.2018.
16. Davies, C. The military hospitals that have closed// Telegraph. co.uk. [electronic resource] URL: https://www.telegraph.co.uk/news/uknews/1530398/The-military-hospitals-that-have-closed.html. Accessed: 23.03.2018.
17. Medical Care for the Armed Forces. Seventh Report of Session 2007-08 House of Commons Defence Committee. 2008. [electronic resource] URL: https://www.nhs.uk/NHSEngland/Militaryhealthcare/Documents/Defence%20Committee.pdf. Accessed: 23.03.2018.
18. NHS: Armed Forces Healthcare: Hospital care. [electronic resource] URL: https://www.nhs.uk/nhsengland/militaryhealthcare/serving/pages/hospitalcare.aspx. Accessed: 23.03.2018.
19. Government of Canada: Canada’s Health Care system. [electronic resource] URL: https://www.canada.ca/en/health-canada/services/canada-health-care-system.html. Accessed: 27.03.2018.
20. The Canadian Institute for Health Information: Who is paying for these health services? [electronic resource] URL: https://www.cihi.ca/en/who-is-paying-for-these-health-services-2017. Accessed: 27.03.2018.
21. National Defence and the Canadian Armed Forces: Spectrum of Care: Medical and Dental Benefits and Services. [electronic resource] URL: http://www.forces.gc.ca/en/caf-community-health-servicesbenefits-drug-coverage/index.page. Accessed: 27.03.2018.
22. National Defence and the Canadian Armed Forces: Medical Coverage, Eligibility, Management and Access to Health Care. [electronic resource] URL: http://www.forces.gc.ca/en/caf-communityhealth-services-benefits-drug-coverage/coverage-eligibilitymanagement-access.page. Accessed: 27.03.2018.
23. National Defence and the Canadian Armed Forces: Canadian Armed Forces Mental Health Services. [electronic resource] URL:
24. http://www.forces.gc.ca/en/caf-community-health-services-mental/index.page. Accessed: 27.03.2018.
25. Veterans Affairs Canada. [electronic resource] URL: http://www.veterans.gc.ca/eng/services/health/treatment-benefits/poc. Accessed: 27.03.2018.
26. Veteran Affairs Canada: How much more is being spent on Veterans’ services? [electronic resource] URL: http://www.veterans.gc.ca/eng/news/info-graphics/4.7-billion. Accessed: 13.04.2018.
27. Barmer: Gesundheitsinformationen. [electronic resource] URL: https://www.barmer.de/gesundheit. Accessed: 27.03.2018.
28. Grunow M., Nuscheler R. Public and private health insurance in Germany: The ignored risk selection problem. Health Economics. 2014; 23 (6): 670-687.
29. Sanitätsdienst Bundeswehr: Startseite. [electronic resource] URL: http://www.sanitaetsdienst-bundeswehr.de/portal/a/sanitaetsdienst/start. Accessed: 27.03.2018. 2
30. Sanitätsdienst Bundeswehr: Institut. [electronic resource] URL: http://www.sanitaetsdienst-bundeswehr.de/portal/a/sanitaetsdienst/start/ueberuns/institut/!ut/p/z1/. Accessed: 27.03.2018.
31. L’ameli: La protection universelle maladie. [electronic resource] URL: https://www.ameli.fr/assure/droits-demarches/principes/protectionuniverselle-maladie. Accessed: 27.03.2018.
32. Chevreul K. et al. France: health system review 2015. Health Systems in Transition. 2015; 17 (3): 1-218. [electronic resource] URL: http://www.euro.who.int/__data/assets/pdf_file/0011/297938/France-HiT.pdf. Accessed: 27.03.2018.
33. Caisse Nationale Militaire de Sécurité Sociale. [electronic resource] URL: https://www.cnmss.fr. Accessed: 27.03.2018.
34. Puolustusvoimat: Sotilaslääketieteen keskus. [electronic resource] URL: http://puolustusvoimat.fi/tietoa-meista/sotilaslaaketieteen-keskus. Accessed: 13.04.2018.
35. The Commonwealth Fund: The French Health Care System. [electronic resource] URL: http://international.commonwealthfund.org/countries/france/. Accessed: 27.03.2018.
36. Chevreul K. et al. France: health system review 2015. Health Systems in Transition. 2015;. 3: 1-218. [electronic resource] URL: http:// www.euro.who.int/_data/assets/pdf_file/0011/297938/France-HiT.pdf. Accessed: 27.03.2018.
37. Interiale Mutuelle. [electronic resource] URL: https://www.interiale.fr/. Accessed: 27.03.2018.
38. Lehtinen S., Rantanen J. National Profile of Occupational Health System in Finland Copenhagen: WHO Regional Office for Europe. national Profile Series. 2012; 70.
39. Puolustusvoimat: Sotilaslääketieteenkeskus. [electronic resource] URL: http://puolustusvoimat.fi/tietoa-meista/sotilaslaaketieteen-keskus. Accessed: 13.04.2018.
40. World Health Organization. The world health report 2000: health systems: improving performance. World Health Organization. 2000.
41. Bloomberg report: Where Do You Get the Most for Your Health Care Dollar? [electronic resource] URL: https://www.bloomberg.com/graphics/infographics/most-efficient-health-care-around-the-world.html. Accessed: 13.04.2018.
42. MINDEF Singapore: Military Medicine Institute. [electronic resource] URL: https://www.mindef.gov.sg/oms/imindef/mindef_websites/atozlistings/safmc/organisation/mmi.html. Accessed: 13.04.2018.
Review
For citations:
Bezdenezhnykh T.P., Lukyantseva D.V. Current practice of organizing and financing the departmental healthcare system for the military in developed countries: a review. FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology. 2018;11(2):68-75. (In Russ.) https://doi.org/10.17749/2070-4909.2018.11.2.068-075
Views: 749
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Email this article 