Kremlin Health Care Optimization Improving Treatment but Only for Those who Can Get It, New Study Shows

Paul Goble

            Staunton, June 7 – Vladimir Putin’s health care “optimization” program which involves cutting the number of smaller health delivery centers and concentrating services in larger ones has in fact generally improved the treatment of those who can get to them but made it far more difficult for many Russians to receive it, according to Sergey Sheyman and Vladimir Shevsky.

            The Higher School of Economics analyst and consultant doctor surveyed 1500 medical providers (“Processes of Concentration and Integration of Medical Services in Foreign Countries and Domestically” (in Russian, Voprosy gosudarsvetnnogo I munitsipalskogo upravleniya, 1 (2019): 111-135 at publications.hse.ru/articles/272892376; summarized at iq.hse.ru/news/281656701.html).

                The logic of unifying smaller health care delivery centers is compelling but not in every respect, Sheyman and Shevsky write. In many rural areas, those who are ill are deprived of accessible medical care; and in large cities, there are now hundreds of thousands of residents relying on each polyclinic.

            Those who can gain access to the larger centers generally but not always get better care: more specialists are available and mortality among these patients has declined, but often the segments of the larger health care centers do not work in close coordination and so that benefit may be lost – and those who can’t gain access are doing worse than before.

            The two also conclude that the cost savings of this program have been exaggerated. There is a one-time cut in the amount of money the state must pay, but over time, that is lost as costs for ambulances and other services increase and as people, failing to get health care early on, show up at treatment centers when their illnesses are worse and costs of treating them higher.