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首页> 外文期刊>Health policy >Two decades of reforms. Appraisal of the financial reforms in the Russian public healthcare sector.
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Two decades of reforms. Appraisal of the financial reforms in the Russian public healthcare sector.

机译：二十年的改革。评估俄罗斯公共卫生部门的金融改革。

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摘要

This paper reviews the empirical evidence on the outcomes of the financial reforms in the Russian public healthcare sector. A systematic literature review identified 37 relevant publications that presented empirical evidence on changes in quality, equity, efficiency and sustainability in public healthcare provision due to the Russian public healthcare financial reforms. Evidence suggests that there are substantial inter-regional inequalities across income groups both in terms of financing and access to public healthcare services. There are large efficiency differences between regions, along with inter-regional variations in payment and reimbursement mechanisms. Informal and quasi-formal payments deteriorate access to public healthcare services and undermine the overall financing sustainability. The public healthcare sector is still underfinanced, although the implementation of health insurance gave some premises for future increases of efficiency. Overall, the available empirical data are not sufficient for an evidence-based evaluation of the reforms. More studies on the quality, equity, efficiency and sustainability impact of the reforms are needed. Future reforms should focus on the implementation of cost-efficiency and cost-control mechanisms; provide incentives for better allocation and distribution of resources; tackle problems in equity in access and financing; implement a system of quality controls; and stimulate healthy competition between insurance companies.
机译：本文回顾了俄罗斯公共医疗保健部门金融改革成果的经验证据。一项系统的文献综述确定了37个相关出版物，这些出版物提供了由于俄罗斯公共医疗金融改革导致公共医疗服务质量，公平，效率和可持续性变化的经验证据。有证据表明，就收入和公共医疗服务的获取而言，各收入群体之间存在很大的地区间不平等现象。区域之间的效率差异很大，而且支付和报销机制的区域间差异也很大。非正式和准形式的付款使获得公共保健服务的机会恶化，并破坏了总体融资的可持续性。尽管医疗保险的实施为将来提高效率提供了一些前提，但公共医疗保健部门仍然资金不足。总体而言，可用的经验数据不足以对改革进行基于证据的评估。需要对改革的质量，公平，效率和可持续性影响进行更多研究。未来的改革应侧重于实施成本效益和成本控制机制;激励人们更好地分配和分配资源;解决获取和融资公平方面的问题;实施质量控制体系;并促进保险公司之间的健康竞争。

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