Preview

FARMAKOEKONOMIKA. Modern Pharmacoeconomic and Pharmacoepidemiology

Advanced search

Overview of the existing opportunities and limitations of the state guarantees program for provision of free medical care to citizens

https://doi.org/10.17749/2070-4909.2019.12.3.221-229

Full Text:

Abstract

Introduction. The state guarantee program for provision of free medical care to citizens is a key regulatory document that describes the actual guarantees of citizens for medical care. The standards of the extent and financing of medical care established in it, determine the level of state guarantees throughout the Russian Federation.

The aim is to determine possible limitations of the state guarantee program within the formation of indicators for the extent of medical care provided in the regions of the Russian Federation and the corresponding financial support.

Materials and methods. As part of the study, the federal and regional regulatory legal acts were analyzed, in terms of the methodology for the formation of regional programs of state guarantees, the extent of medical care and financing, as well as the methodology for the formation of these standards.

Results. The existing mechanisms for adapting the federal program of state guarantees at the regional level have been identified, and it has been shown that in most regions of the Russian Federation these methods are not used. Objective criteria for differentiating the standards of medical care exist in 77 regions, these standards correspond to the federal level in the vast majority of the regions of the Russian Federation, however there is a financing gap of the territorial programs in 2017 using the regional budget in 70 regions of the Russian Federation.

Findings. The current recommendations on formation of the territorial program of state guarantees are applied to a limited extent. Calculation of the per capita financing standard for a region of the Russian Federation depends only on the differentiation coefficient; incidence rate, age and gender structure of population in a region are not taken into account while calculating the subvention amount.

 

About the Authors

D. V. Fedyaev 
Research Institute of Finance, Ministry of Finance of the Russian Federation; Russian Presidential Academy of National Economy and Public Administration, Federal State Educational Institution of Higher Professional Education; Center for Healthcare Quality Assessment and Control of the Ministry of Healthcare of the Russian Federation
Russian Federation
Deputy Head of the Department for Methodological Support of Payment for Medical Care, Center for Expertise and Quality Control of Medical Care, Ministry of Health of the Russian Federation; Research Fellow at the Laboratory for HTA, Institute of Applied Economic Research of the Russian Academy of Science, Research Associate at the Health Care Finance Research Center


R. V. Gostishchev 
Research Institute of Finance, Ministry of Finance of the Russian Federation; Center for Healthcare Quality Assessment and Control of the Ministry of Healthcare of the Russian Federation
Russian Federation
research assistant, Center for Intergovernmental Relations, Research Institute of Finance; Leading Specialist, Development and External Communications, Center for Healthcare Quality Assessment and Control of the Ministry of Healthcare of the Russian Federation


V. A. Lemeshko 
Research Institute of Finance, Ministry of Finance of the Russian Federation; Center for Healthcare Quality Assessment and Control of the Ministry of Healthcare of the Russian Federation; Sechenov University
Russian Federation
research assistant, Health Finance Center, Research Institute of Finance; Leading Specialist, Department of Methodological Support of Comprehensive HTA, Center for Healthcare Quality Assessment and Control, Ministry of Healthcare of the Russian Federation; Post-graduate Student at the Department of Pharmacology, Institute of Pharmacy and Translational Medicine, Sechenov University


O. I. Ivakhnenko 
Research Institute of Finance, Ministry of Finance of the Russian Federation
Russian Federation
Researcher, Health Finance Center


References

1. Men M.A. Report on the results of the expert-analytical event “analysis of the formation in 2017 and 2018 and the implementation in 2017 of territorial programs of state guarantees of free medical care for citizens, including their financial guaranty” (in Russ.).

2. Sura M.V. Planning of extent and financial expenses for delivery of health care in hospitals at the federal and regional levels. FARMAKOEKONOMIKA. Modern Pharmacoeconomic and Pharmacoepidemiology. 2015; 8 (4): 21-27. (In Russ.) https://doi. org/10.17749/2070-4909.2015.8.4.021-027

3. Fedyaev D.V., Melnikova L.S., Ignatyeva V.I. Review of practice and possible directions of concretization the program of state guarantees for free medical care for russian citizens. FARMAKOEKONOMIKA. Modern Pharmacoeconomic and Pharmacoepidemiology. 2016; 9 (4): 38-45. (In Russ.) https://doi. org/10.17749/2070-4909.2016.9.4.038-045.

4. Nikulina N. N., Malysheva S. A., Arzhadeeva E. O. Features of the calculation of average standards for the volume of medical care of territorial compulsory medical insurance in the constituent entities of the Russian Federation. Strakhovoe delo (In Russ.). 2016; 6: 35-41.

5. Russia in numbers. 2018: Short Stats / Rosstat. Moscow. 2018; 522 s. (In Russ.).

6. Daikhes A.N., Fedyaev D.V. Provision of free medical care in Russia and elsewhere: review of regulatory and legal aspects. FARMAKOEKONOMIKA. Modern Pharmacoeconomic and Pharmacoepidemiology. 2017; 10 (3): 59-65. (In Russ.) https://doi.org/10.17749/2070-4909.2017.10.3.059-065

7. Barkhatova E.Yu. Commentary on the Constitution of the Russian Federation (itemized). 2nd ed., Revised. and add. Moscow. 2015; 272 p. (In Russ.).

8. The Constitution of the Russian Federation (adopted by popular vote 12/12/1993) (as amended by the Laws of the Russian Federation on amendments to the Constitution of the Russian Federation dated December 30, 2008 N 6-FKZ, dated 30.12.2008 N 7-FKZ, dated 05.02.2014 N 2-FKZ , dated July 21, 2014 N 11-FKZ) (In Russ.).


For citation:


Fedyaev  D.V., Gostishchev  R.V., Lemeshko  V.A., Ivakhnenko  O.I. Overview of the existing opportunities and limitations of the state guarantees program for provision of free medical care to citizens. FARMAKOEKONOMIKA. Modern Pharmacoeconomic and Pharmacoepidemiology. 2019;12(3):221-229. (In Russ.) https://doi.org/10.17749/2070-4909.2019.12.3.221-229

Views: 314


ISSN 2070-4909 (Print)
ISSN 2070-4933 (Online)