ACTUAL PROBLEMS OF HEALTHCARE FINANCING TAKING INTO ACCOUNT THE EXPERIENCE OF THE REPUBLIC OF BASHKORTOSTAN
Abstract
Health care supports and ensures the public health of the nation, which is one of the most important indicators of the quality of life in the country. A healthy population speaks of the social and economic development of the state. In modern conditions, providing population with affordable and high-quality medical care and financing the health care system have acquired particular relevance. The article provides a historical analysis of the rules of law that established the sources of funding for health care in the past, as well as an analysis of the current procedure of financial supporting of the health care system and the difficulties faced by medical care in the Russian Federation today. The article formulates the ways of solving the existing problems, in order to improve medical services, to increase the efficiency of the financing the medical institutions, including educational ones, in order to develop medical science, and prepare qualified medical staff.
Purpose. Investigate particular qualities of the formation of financing of the health care system in the Russian Federation, as well as to analyze the current problems, which are revealed themselves because of the financing deficient of health care in Russia.
Materials and methods. The article analyzes the rules of law establishing the order of financial support of the health care system, from the times of Ancient Rus to the present day. The federal budget’s expenditures from 2017 to 2019 for the needs of the healthcare system were compared with other expenditures. The obtained data were processed by methods of nonparametric statistics. Quantitative characteristics are presented in the form of a table.
Results. The annually allocated budget for health care was no more than 2.5% of GDP. In connection with the current financing of health care, some problems revealed themselves: a shortage of qualified medical workers, insufficient motivation of students to continue their professional medical practice, inconsistency of financial support between regions, the level of Russian pharmacy does not correspond to modern requirements.
Conclusion. Thus, the problem of insufficient financing of health care is relevant and indicates the necessity of the develop measures aimed at stabilizing the health care system of the state, modernizing it in the future in order to provide the country’s population with affordable and high-quality health care.
Downloads
References
Belyakov A.V. Opyt Evropeyskogo Soyuza v oblasti regulirovaniya zdravookhraneniya [Experience of the European Union in the field of healthcare regulation]. M.: Justicinform, 2015, 320 p.
Besedovsky S.G., Zharkova Yu.S., Tsoi R.A., Schemelev S.N. Finansovye issledovaniya, 2015, no. 1 (46), pp. 129-137. https://finis.rsue.ru/2015_N1/besedovskiy-zarkova-coi-shemelev.pdf
Bratanovskiy S.N., Kizilov V.V. Pravovoe regulirovanie organiza-tsii i deyatel’nosti meditsinskikh uchrezhdeniy v Rossii [Legal regulation of the organization and activities of medical institutions in Russia] / S.N. Bratanovsky (ed.). Saratov: Izd-vo Sarat. un-ta, 2005, 110 p.
Vladimirskiy-Budanov M.F. Obzor istorii russkogo prava [Review of the history of Russian law]. Rostov-on-Don: Phoenix Publ., 1995, 640 p.
Duganov M.D. Otsenka effektivnosti raskhodov na zdravookhranenie na regional’nom i munitsipal’nom urovnyakh : monografiya [Assessment of the effectiveness of health care expenditures at the regional and municipal levels: monograph]. M., 2007, 112 p.
Droshev V.V. Razvitie obyazatel’nogo meditsinskogo strakhovaniya v Rossii: istoriya i sovremennost [The development of compulsory medical insurance in Russia: history and modernity]. Strakhovoe delo, 2004, № 1, pp. 47-59.
Komarov Yu.M. ORGZDRAV: novosti, mneniya, obuchenie. Vestnik VSHOUZ [Healthcare Management: News, Views, Education. Bulletin of VSHOUZ], 2019, vol. 5, no. 3(17), pp. 32-35. https://doi.org/10.24411/2411-8621-2019-13004
Kuzmin M.K. Istoriya meditsiny [History of Medicine]. M.: Medicine Publ., 1978. 199 p.
Mirsky M.B. Meditsina Rossii XVI-XIX vekov [Medicine of Russia of the XVI-XIX centuries]. M.: Rosspen, 1996, 376 p.
Nazarov V.S., Avksentev N.A., Sisigina N.N. Osnovnye napravleniya razvitiya sistemy zdravookhraneniya Rossii: trendy, razvilki, stsenarii [The main directions of development of the healthcare system in Russia: trends, forks, scenarios]; RANEPA. Moscow: Delo Publ., 2019, 102 p.
Zabelin M.V. O kadrovom obespechenii otrasli zdravookhraneniya Respubliki Bash-kortostan, v tom chisle sistemy okazaniya skoroy meditsinskoy pomoshchi, i merakh sotsial’noy podderzhki meditsinskikh rabotnikov [On the staffing of the healthcare industry in the Republic of Bash-kortostan, including the emergency medical care system, and measures of social support for medical workers]. https://health.bashkortostan.ru/presscenter/lectures/1188/
Vishnyakov N.I. et al. Osnovy ekonomiki zdravookhraneniya [Fundamentals of Health Economics]; N.I. Vishnyakov, V.A. Minyaev (ed.). Moscow: MEDpress-inform, 2008, 144 p.
Polnoe sobranie zakonov Rossiyskoy imperii [Complete collection of laws of the Russian Empire], 1830, vol. 5, no. 2821.
Rossiyskoe zakonodatel’stvo X-XX vekov: Zakonodatel’stvo perioda obrazovaniya i ukrepleniya Russkogo tsentralizovannogo gosudarstva. V 9-ti tomakh. T. 2 [Russian legislation X-XX centuries: Legislation of the period of formation and strengthening of the Russian centralized state. In 9 volumes. Vol. 2] / Gorsky A.D. (ed.); Chistyakova O.I. M.: Legal literature Publ., 1985, 520 p.
Stolyarov S.A. Menedzhment v zdravookhranenii: uchebnik dlya vuzov [Management in health care: a textbook for universities]. M.: Yurayt Publ., 2019, 764 p.
Ulumbekova G.E., Ginoyan A.B., Kalashnikova A.V., Alvianskaya N.V. ORGZDRAV: novosti, mneniya, obuchenie. Vestnik VSHOUZ [Healthcare Management: News, Views, Education. Bulletin of VSHOUZ], 2019, vol. 5, no. 4, pp. 4-19. https://doi.org/10.24411/2411-8621-2019-14001
Federal’nyy byudzhet na 2017-2019 gody: o chem govoryat ego osnovnye parametry [Federal budget for 2017-2019: what its main parameters indicat]. https://www.finam.ru/analysis/forecasts/federalnyiy-byudzhet-na-2017-2019-gody-o-chem-govoryat-ego-osnovnye-parametry-20161024-13320/
Khrestomatiya po istorii otechestvennogo gosudarstva i prava (posle-oktyabr’skiy period) [Reader on the history of the national state and law (post-October period)] / Yu.P. Titov, O.I. Chistyakov. M.: Moscow State University Publ., 1994, 446 p.
Shishkin S.V. Reforma finansirovaniya rossiyskogo zdravookhraneniya: monografiya [Financing reform of Russian health care: monograph]. M., 2000, 444 p. https://www.iep.ru/files/text/working_papers/25.pdf
Dzau V.J., McClellan M.B., McGinnis J. M., Finkelman E.M., Editors. Vital Directions for Health and Health Care: An Initiative of the National Academy of Medicine. Washington (DC): National Academy of Medicine, 2017, pp. 1-38. https://nam.edu/initiatives/vital-directions-for-health-and-health-care/vital-directions-for-health-health-care-special-publication/
Ezekiel J. Emanuel Which Country Has the World’s Best Health Care? New York: PublicAffairs, 2020. 464 r. https://www.publicaffairsbooks.com/titles/ezekiel-j-emanuel/which-country-has-the-worlds-best-health-care/9781541797727/
Nosova D., Nosov I., Filippov N.L., Bikkinin I. Prevention Of Minors Delinquent Behavior In Activities Of The Internal Affairs Officers. European Proceedings of Social and Behavioural Sciences EpSBS. Humanistic Practice in Education in a Postmodern Age (HPEPA 2019), 2019, pp. 791-798.
Smith M, Saunders R, Stuckhardt L, McGinnis JM, editors. Best Care at Lower Cost: The Path to Continuously Learning Health Care in America. Washington, DC: The National Academies Press, 2013, 436 p. https://doi.org/10.17226/13444
Shrank WH, DeParle N, Gottlieb S, Jain SH, Orszag P, Powers BWet al. Health Costs and Financing: Challenges and Strategies for a New Administration. Health Affairs, 2021, vol. 40, no. 2, pp. 235-242. https://doi.org/10.1377/hlthaff.2020.01560
Tanner M.D. The Grass is Not Always Greener: A Look at National Health Care Systems around the World. Policy Analysis, March 18, 2008, no. 613, pp. 1-48. https://doi.org/10.2139/ssrn.1262978
Copyright (c) 2021 Tatyana V. Ermolenko, Irek A. Bikkinin
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
