Providing free high-tech medical care in Russia – analysis of the practice

Nesterova A. V.
student¹

Krasnopolskaya I. I.
MA in Sociology; lecturer¹

1 - State and Municipal Administration Faculty at Higher School of Economics

The article analyzes practical issues of providing high-tech care through a quota system. The principal idea of the article is to access the possible impact of inclusion of high-tech care in general health insurance on convenience of its receiving. Referral algorithm for high-tech care is described, problems of practice for granting high-tech care through quota system are analyzed. An estimate is made, that the problems described may be tackled by inclusion of high-tech care in general health insurance.

The article is based on contextual analysis of ways of directing citizens for high-tech care, studies of high-tech care centers geographical location and an empirical study on high-tech care provided for patients with upper urinary tract cancer in one of the cancer clinics in the city of Moscow (as of 2014).

Material for producing a contextual analysis article was about the direction of citizens to VMP, studying geography location centers for VMP, and the results of empirical research to provide patients with upper urinary tract cancer in one of the cancer centers in the city of Moscow (as of 2014). A semiformalized depth interview based on a plan containing a list of question wording was chosen as a research method. The study surveyed the following target groups: doctors, patients, representatives of non-profit organizations working in the health sector, the former employees of the Ministry of Health.

Interview results suggest that the algorithm for providing high-tech care through a quota system is confusing for the patient and the very practice of high-tech care provision diverges with standards established by law. At the same time, only a portion of the existing problems can be solved by inclusion of high-tech care into general health insurance framework. The authors believe that the results can be used to improve existing algorithms for high-tech care provision.

high-tech care, quotas, cancer patients, general health insurance

1. Ministry of Health Care and Social Development of the Russian Federation, order No 1689n of 28 December 28, 2011 «On approval of the guidelines for providing high-tech medical care to the Russian Federation citizens, at the expense of the budget allocations in the federal budget to the Ministry of Health and Social Development of the Russian Federation, with the use of specialized information system.»

2. Ministry of Health Care and Social Development of the Russian Federation, order No 138n of 16 February 16, 2011 «On Amendments to the Order of the Ministry of Health and Social Development of the Russian Federation of April 16, 2010 N 242n ”On Approval and Keeping of forms for statistical accounting and reporting on government assignment for providing high-tech medical care to the Russian Federation citizens at the expense of the budget allocations in the federal budget.”»

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4. Ministry of Health Care of the Russian Federation, order No 916n of 10 December, 2013 «On the list of high-tech medical care forms.»

5. Federal Law of May 2, 2006 No 59-FZ (rev. of July 2, 2013) «On Examination Procedure for Applications from the Russian Federation Citizens.»

6. Ministry of Health Care of the Russian Federation, order No 1117n «On Adoption of the List of Health Care Institutions for providing high-tech medical care to the Russian Federation citizens at the expense of the budget allocations in the federal budget.»

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8. Federal Law of April 12, 2010 No 61-FZ (rev. of March 12, 2014) «On Examination Procedure for Applications from the Russian Federation Citizens.”On Medicines Turnover.”»

9. Official web-site of Patient’s League. URL: http://ligap.ru/aboutus/lica/

10. Assessment of state services regulation practice. Mass state services (state services for citizens). In «Monitoring of quality and availability of state and municipal services» Moscow: Higher School of Economics, 2010: 41-55. Print.