Urban inequity in the performance of social health insurance system: evidence from Russian regions

The paper assesses the impact of urbanization on the quality related outcomes of social health insurance systems in 85 Russian regions in 2000-2006. The results of parametric and kernel regressions reveal that controlling for regional income is a significant determinant of infant and under-five mortality. Arguably, the influence of urbanization on health outcomes is due to latent processes (e.g. the development of infrastructure). The methods of provider reimbursement are related to infant and under-five mortality, which offers suggestive evidence for selective contracting. Yet, insurer competition might increase urban inequity.