Formal and Informal Rules of Out-Pocket Payments for Health Care in Russia

Abstract

The key problem of Russian health care is a gap between state guarantees of free medical care and its financial provision, which led to the growth of both legal and informal expenses of the patients on purchase of medicines and payment for medical services and also to the deterioration of access to high quality medical assistance for the majority of the population.
This article gives the main results of the research of the rules of out-pocket payments for health care, conducted under the direction of the author in the Independent Institute of Social Policy in 2002-2003 in the framework of two research projects:
«The analysis of the consequences of various strategies of the financial provision of state guarantees in health care»; the project was carried out with financial assistance of Moscow public scientific foundation and USAID; members of the research: S.V.Shishkin (project director), T.V.Bogatova, E.G.Potapchik, V.A.Chernetc, A.E.Chirikova, L.S.Shilova;
«The analysis of interconnection between formal and informal rules of social services provision using the example of payments for health care»; the project was carried out with financial assistance of Ford Foundation; members of the research: S.V.Shishkin (project director), G.E.Besstremyannaya, M.D.Krasilnikova, L.N.Ovcharova, M.V.Savelyeva.
The data have been collected during 171 interviews with health care managers, physicians, nurses and during survey of 3300 households in two regions.