Public Spending in Russia for Health Care : Issues and Options

This report examines three critically important areas to inform discussions on the appropriate level of health care spending in the Russian Federation: (i) the efficiency of spending on health care services; (ii) distributional impacts of spending on health care services; and (iii) the key factors that will influence the growth in health care spending over the next 20 years. There are few data showing how spending in health care in the Russian Federation translates into better health outcomes such as improved mortality, improved morbidity, increased economic output and productivity, improvements in the number of life years gained, or more sophisticated composite measures such as Quality Adjusted Life Years (QALYs). There is also limited data on outputs of hospitals and other healthcare providers which allow controlling for case mix, socioeconomic status, supply-side variables, and quality of care. Therefore, it is difficult to assess the efficiency or distributional impacts of health interventions. While the analysis draws on primary data specifically collected for the study, the absence of detailed output and outcome data necessarily limits the scope of the study and its findings.