INTER-TERRITORIAL CALCULATIONS FOR IDENTIFYING IMBALANCES AND PROBLEMS IN HEALTH INSURANCE
Abstract and keywords
Abstract (English):
The current strategic goals in the national public healthcare require improving its quality and availability, which implies effective financial management in the compulsory health insurance system. Regional compulsory health insurance funds provide citizens with free medical care as part of state healthcare programs. The article introduces an in-depth analysis of the revenue and expenditure budget structure of regional compulsory health insurance funds with a focus on the inter-territorial calculations. The analysis made it possible to propose a system of measures to make the funds more effective by improving their management. A review of various approaches to financial assessment revealed that the formal balance, which supposedly reflects the financial stability of the health insurance system, cannot be considered as a reliable indicator. Only an objective assessment could reveal the obscure imbalances, local financial disproportions, and issues connected with the inter-regional distribution. The authors conducted an in-depth analysis of the dynamics of the budget, income, and expenses provided by the Siberian compulsory health insurance funds in 2009–2024. The assessment of inter-territorial financial flows caused by patient migration revealed a correlation between the indicators of the outflow of patients seeking medical care in other regions and the socio-demographic factors. By optimizing the identified imbalances and increasing the medical attractiveness, regions could improve the financial and economic mechanism of their compulsory health insurance systems, as well as ensure their sustainable development.

Keywords:
compulsory medical insurance, inter-territorial calculations, structural budget analysis, medical tourism, patient outflow, medical attractiveness of regions
Text
Text (PDF): Read Download
References

1. Astapov K. L., Musaev R. A., Malakhov A. A. Evaluating the effectiveness of the budget expenditure policy. Financial Journal, 2020, 12(6): 9–24. (In Russ.) https://doi.org/10.31107/2075-1990-2020-6-9-24

2. Kalmykov Yu. P. Improvement of the health insurance system. Strakhovoe delo, 2022, (9): 46–58. (In Russ.) https://elibrary.ru/lnuejm

3. Gradoboev E. V., Solskaya I. Yu. Ensuring the financial stability of the compulsory health insurance system. Bulletin of Baikal State University, 2022, 32(3): 485–492. (In Russ.) https://doi.org/10.17150/2500-2759.2022.32(3).485-492

4. Gurvich E. T., Krasnopeeva N. A. Analysis of tax-spend nexus for Russian regional budgets. Voprosy ekonomiki, 2020, (2): 5–29. (In Russ.) https://doi.org/10.32609/0042-8736-2020-2-5-29

5. Babkina L. N., Skotarenko O. V., Tsareva S. V. Financing of the healthcare system. Economy. Profession. Business. 2023, (3): 12–19. (In Russ.) https://doi.org/10.14258/epb202332

6. Kadyrov F. N., Obukhova O. V., Mitroshin P. V., Chililov A. M. Prospects for the financial provision and functioning of the compulsory health insurance system. Manager Zdravoochranenia, 2024, (2): 116–126. (In Russ.) https://doi.org/10.21045/1811-0185-2024-3-116-126

7. Gayfullin A. N. Sectoral features of regional healthcare and problematic aspects of evaluating its effectiveness. Vestnik Rossiiskogo universiteta kooperatsii, 2021, (4): 16–22. (In Russ.) https://elibrary.ru/lqxjbp

8. Krivenko N. V. The level of medical care accessibility in Russia: Regional differentiation. Journal of New Economy. 2024, 25(2): 89–107. (In Russ.) https://doi.org/10.29141/2658-5081-2024-25-2-5

9. Obukhova O. V., Mitroshin P. V., Chililov A. M. The mandatory health insurance system: Towards equitable distribution of funds. Strakhovoe delo, 2022, (10): 43–52. (In Russ.) https://elibrary.ru/mxlxjq

10. Lukyantseva D. V., Popov A. A., Fediaev D. V. Efficiency of budget expenditure management in the field of healthcare in terms of implementing the Program of state guarantees of free medical care to citizens, taking into account health indicators. Topical Issues of the Modern Economy, 2021, (11): 821–833. (In Russ.) https://doi.org/10.34755/IROK.2021.15.67.003

11. Rudakova O. V., Makunina I. V., Guseva A. V. Budget formation of territorial compulsory medical insurance fund (on the example of the Tver FMIF (Federal Medical Insurance Fund)). Economic environment, 2024, 13(2): 99–106. (In Russ.) https://doi.org/10.36683/ee242.99-106

12. Igonina L. L. Instruments of inter-budgetary regulation and ensuring financial independence of territories. Eurasian economic integration and sustainable development in the context of global transformations: Proc. Intern. Sci.-Prac. Conf., Yerevan, 27–30 Apr 2023. Krasnodar: HELRI, 2023, 41–46. (In Russ.) https://elibrary.ru/wxkbkg

13. Reprintseva E. V. Condition and problems of financial support of the Russian healthcare system. Azimuth of Scientific Research: Economics and Administration, 2021, 10(1): 264–267. (In Russ.) https://doi.org/10.26140/anie-2021-1001-0064

14. Kukonkov P. I., Ustinkin S. V. Inequalities and disparities in the regional health system. Obozrevatel, 2023, (1): 70–80. (In Russ.) https://doi.org/10.48137/2074-2975_2023_1_70

15. Gurina A. E., Dzulaeva I. Iu., Alikova Z. R., Kornetov A. N., Totrov I. N., Ulubieva E. A., Zolkin A. L., Domnichev D. Iu., Lesnova N. I., Dzobelova V. B. Improving the financing of health systems: International experience. Ufa: Aeterna, 2024, 186. (In Russ.) https://elibrary.ru/sefhjg

16. Malysheva A. A. The role of territorial compulsory medical insurance funds in the distribution of compulsory medical insurance funds. Electronic Supplement to the Russian Law Journal, 2021, (1): 46–49. (In Russ.) https://doi.org/10.34076/22196838_2021_1_46

17. Rudakova O. V., Stebletsova N. N., Lisichkina N. V. Compulsory medical insurance in financing system of public health in Russia. Science Outpost, 2024, 18(1): 81–88. (In Russ.) https://doi.org/10.22394/sp241.81-88

18. Buranbayeva L. Z., Sabirova Z. E. Key challenges of the healthcare system in modern conditions. Herald of GSTOU. Humanitarian, social and economic sciences, 2024, 20(1): 5–14. (In Russ.) https://elibrary.ru/joolfg

19. Seliverstov P. V. Prospects for the use of telemedicine technologies based on artificial intelligence during medical examination. Meditsinskiy Sovet, 2024, 18(5): 312–319. (In Russ.) https://doi.org/10.21518/ms2024-072

20. Ponomareva O. N. Digitalization in medicine: Advantages and disadvantages. Sistemnaia integratsiia v zdravookhranenii, 2023, (4): 108–121. (In Russ.) https://elibrary.ru/feytbn

21. Ivliev P. V. Prospects of application of digital technologies in medicine. Agrarian and Land Law, 2023, (6): 28–30. (In Russ.) https://elibrary.ru/ubozax

22. Karailanov M. G., Uzhokh-Bazhnokov O. A., Moiseeva K. E., Alekseeva A. V., Daineko M. Yu., Gorlanov I. A. The main directions of improving dispensary monitoring of patients using digital technologies. Medicine and Health Care Organization, 2024, 9(1): 136–150. (In Russ.) https://doi.org/10.56871/MHCO.2024.40.98.011

23. Timurzieva A. B., Lindenbraten A. L. On certain issues of modern health care system development. Problemi socialnoi gigieni, zdravookhranenia i istorii meditsini, 2024, 32(4): 723–730. (In Russ.) https://doi.org/10.32687/0869-866X-2024-32-4-723-730

24. Tishutin A. A. Financial aspects of healthcare development. Problemi socialnoi gigieni, zdravookhranenia i istorii meditsini, 2024, 32(S1): 664–669. (In Russ.) https://doi.org/10.32687/0869-866X-2024-32-s1-664-669


Login or Create
* Forgot password?