Two decades of reforms. Appraisal of the financial reforms in the Russian public healthcare sector

Gordeev, VS; Pavlova, M; Groot, W; (2011) Two decades of reforms. Appraisal of the financial reforms in the Russian public healthcare sector. Health policy (Amsterdam, Netherlands), 102 (2–3). pp. 270-277. ISSN 0168-8510 DOI:

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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.

Item Type: Article
Keywords: The Russian Federation, Healthcare, Equity, Efficiency, Sustainability, Evidence-based reform evaluation, Economic Competition, Financing, Organized, Government Regulation, Health Care Reform, organization & administration, Health Policy, Health Services Accessibility, Health Services Administration, Healthcare Disparities, Humans, National Health Programs, organization & administration, Public Sector, economics, Quality of Health Care, Russia
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: ECOHOST - The Centre for Health and Social Change
PubMed ID: 20832892
Web of Science ID: 295704200019


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