Financial protection in health in Russia

Abstract: 
The work is devoted to the analysis of the financial protection of households when using medical services in Russia. Among the key indicators that determine the level of protection of families from financial burdens when using health-related services, the following were selected: out-of-pocket spending on health care, catastrophic personal payments and wasteful payments that lead to family impoverishment, and index of essential health services. Analysis of financial protection in Russia based on these indicators led to the following conclusions. The indicators of financial protection in Russia look quite satisfactory — both in terms of catastrophic spending and in terms of the indicator of impoverishment of the population due to personal expenses for medical care. However, this is due not so much to financial security and government support of the population, but to the fact that a large number of households cannot afford to spend money on medical services. The low index of essential health services in our country indicates that a significant number of people do not use medical care, even when it is needed.

Keywords:

doi: 

10.25990/socinstras.pss-15.yjeh-nn48

For citation: Panova L.V., Kupriyanov L.A. Financial protection in health in Russia. St. Petersburg Sociology Today. 2021. N. 15. P. 5-19. DOI:10.25990/socinstras.pss-15.yjeh-nn48

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References: 
  • Arrow K. Uncertainty and the welfare economics of medical care. The American Economic Review, 1963, no. 53, pp. 941-973.
  • Berki S. A look at catastrophic medical expenses and the poor. Health Affairs, 1986, vol. 5 (4), pp. 138-145. DOI: 10.1377/hlthaff.5.4.138.
  • Boerma T., Abou Zahr C., Evans D., Evans T. Monitoring intervention coverage in the context of universal health coverage. PLoSMed, 2014, vol. 11 (9), p. e1001728.
  • Cavagnero E., Carrin G., Xu K., Aguilar-Rivera A. Health financing in Argentina: an empirical study of health care expenditure and utilization. WHO. Innovations in Health Financing: Working Paper Series, 8, 2006.
  • Chubarova T. V. Dokhody i potreblenie meditsinskikh uslug: opyt analiza s pozitsii teorii opekaemykh blag [Income and consumption of medical services: an analysis experience from the perspective of the theory of trusteeship]. Zhurnal novoy ekonomicheskoy assotsiatsii [Journal of the New Economic Association], 2020, vol. 47 (3), pp. 190-196. (In Russian)
  • Doorslaer E., O’Donnell O. et al. Effect of payments for health care on poverty estimates in 11 countries in Asia: an analysis of household survey data, 2006, no. 368, pp. 1357-1364. DOI: 10.1002/hec.1209.
  • Hogan D., Stevens G., Hosseinpoor A., Boerma T. Monitoring universal health coverage within the Sustainable Development Goals: development and baseline data for an index of essential health services. Lancet Global Health, 2018, no. 6, p. e152-168. DOI: 10.1016/ S2214-109X(17)30472-2.
  • Hsu J., Flores G., Evans D., Mills A., Hanson K. Measuring financial protection against catastrophic health expenditures: methodological challenges for global monitoring. International Journal for Equity in Health, 2018, no. 17, pp. 69-72.
  • Jowett M., Brunal M., Flores G., Cylus J. Spending targets for health: no magic number. Geneva. WHO. Health Financing Working Paper, 2016, no. 1. DOI: 10.1186/s12939-018-0749-5.
  • Kwon E., Park S., McBride T. Health Insurance and Poverty in Trajectories of Out-ofPocket Expenditure among Low-Income Middle-Aged Adults. Health Services Research, 2018, vol. 53 (6), pp. 4332-4352.
  • Mossialos E. Obzor global’nykh tendentsiy v razvitii zdravookhraneniya [Review of Global Trends in Healthcare Development]. Vestnik VShOUZ. [Bulletin of the High School of Organisation and Health Management], 2019, vol. 5 (2), pp. 57-79. (In Russian)
  • Pradhan M., Prescott N. Social risk management options for medical care in Indonesia. Health Economics, 2002, no. 11, pp. 431-446.
  • Saksena P., Hsu J., Evans D. Financial risk protection and universal health coverage: evidence and measurement challenges. PLoS med, 2014, vol. 11 (9), p. e1001701. DOI: 10.1371/journal.pmed.1001701.
  • Shishkin S. V., Potapchik E. G., Selezneva E. V. Oplata patsientami meditsinskoy pomoshchi v rossiyskoy sisteme zdravookhraneniya [Payment by patients for medical care in the Russian health care system]. Moscow: Ed. House of the HSE, 2014. (In Russian)
  • Thomson S., Figueras J. et al. Economic Crisis, Health Systems and Health in Europe: Impact and implications for policy. WHO/European Observatory on Health Systems and Policies. Copenhagen, Open University Press, 2015.
  • Thomson S., Evetovits T., Cylus J., Jakab M. Monitoring financial protection to assess progress towards universal health coverage in Europe. Public health panorama, 2016, vol. 2 (3), pp. 358-400.
  • United Nations. Resolution adopted by the General Assembly on 25 September 2015. Transforming our world: the 2030 Agenda for Sustainable Development (A/70/1). 2015.
  • Wagstaff A., Van Doorslaer E. Catastrophe and impoverishment in paying in health care: with applications to Vietnam 1993-98. Health Economics, 2003, vol. 12 (11), pp. 921-934. DOI: 10.1002/hec.776.
  • Wagstaff A., Flores G., Hsu J., Smitz M., Chepynoga K., Buisman L., Wilgenburg K., Eozenou P. Progress on catastrophic health spending in 133 countries: a retrospective observational study. Lancet Global Health, 2018, vol. 6 (2), pp. e169-179. DOI: 10.1016/ S2214-109X(17)30429-1.
  • WHO. WorldHealth Report — Health systems: improving performance. Geneva, 2000.
  • WHO. Fifty-eighth world health assembly. Social health insurance Sustainable health financing, universal coverage and social health insurance. Report by the Secretariat. Geneva, 2005.
  • WHO. The WorldHealth Report Health systems financing: the path to universal coverage. Geneva, 2010.
  • WHO, World Bank. Monitoring progress towards universal health coverage at country and global levels. Framework, measures and targets. Geneva, 2014.
  • WHO, World Bank. Tracking Universal Health Coverage: 2017 Global Monitoring Report, 2017.
  • WHO. Global Health Expenditure Database WHO. Health System Financing Profile by country. URL: https://apps.who.int/nha/database/country_profile/Index/en (access date: 10.05.2021).
  • WHO. World health statistics 2019: monitoring health for the SDGs, sustainable development goals. Geneva: World Health Organization. 2019b.
  • Wyszewianski L. Financially catastrophic and high-cost cases: definitions, distinctions, and their implications for policy formulation. Inquiry, 1986, vol. 23 (4), pp. 382-394.
  • Xu K., Evans D., Kawabata K., Zeramdini R., Klavus J., Murray C. Household catastrophic health expenditure: a multicountry analysis. Lancet, 2003, vol. 362 (9378), pp. 111-117. DOI: 10.1016/S0140-6736(03)13861-5.
  • Xu K., Soucat A., Kutzin J., Brindley C., Maele N., Toure H., Garcia M., Li D., Barroy H., Flores G., Roubal T., Indikadahena C., Cherilova V., Siroka A. Public spending on health: a closer look at global trends. Geneva: World Health Organization. 2018.
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