Papers by Elena Potapchik
Profilakticheskaya meditsina, 2022
HEALTH CARE OF THE RUSSIAN FEDERATION
In the 21st century, more and more attention is paid to long-term forecasts for the development o... more In the 21st century, more and more attention is paid to long-term forecasts for the development of countries, regions and the world as a whole; the scope of their application is expanding, including the coverage of social sectors, and, above all, healthcare. Acquaintance with the existing foreign and domestic practice of developing long-term forecasts can be useful not only for those involved in their development, but also for decision makers in the healthcare sector. The purpose is generalization and systematization of published long-term forecasts in healthcare. Systematic search for publications according to the developed protocol. The protocol included databases of peer-reviewed publications, search terms, and search restrictions. The search for publications was carried out in the databases including Embase, Medline, Scopus, RSCI, etc. The search query was carried out using a combination of terms “free text” and “medical subject headings” related to the definition of long-term f...
Profilakticheskaya meditsina
Health Economics Review
Вackground In the last two decades, health care systems (HCS) in the European countries have face... more Вackground In the last two decades, health care systems (HCS) in the European countries have faced global challenges and have undergone structural changes with the focus on early disease prevention, strengthening primary care, changing the role of hospitals, etc. Russia has inherited the Semashko model from the USSR with dominance of inpatient care, and has been looking for the ways to improve the structure of service delivery. This paper compares the complex of structural changes in the Russian and the European HCS. Methods We address major developments in four main areas of medical care delivery: preventive activities, primary care, inpatient care, long-term care. Our focus is on the changes in the organizational structure and activities of health care providers, and in their interaction to improve service delivery. To describe the ongoing changes, we use both qualitative characteristics and quantitative indicators. We extracted the relevant data from the national and internationa...
Profilakticheskaya meditsina
Profilakticheskaya meditsina
HEALTH CARE OF THE RUSSIAN FEDERATION, 2021
There has been an active discussion on estimating the need for public funding of the domestic hea... more There has been an active discussion on estimating the need for public funding of the domestic health system. An analysis of international experience can be helpful to determine methodological approaches to estimate the market for government spending on the Russian health system. Aim. To systemize and summarize approaches and methods used in international practice to estimate the need for health financing; to highlight the most important factors dictating the need for additional funding. Material and methods. A systematic search with the developed protocol for publications, a comprehensive analysis and systematization of the obtained information. The protocol included databases of peer-reviewed publications, search terms, and search restrictions. The search for publications was carried out in the databases of Embase, Pubmed, Medline, Global Health, etc., on the websites of international organizations (World Health Organization (WHO), Organization for Economic Cooperation and Developm...
Problems of Economic Transition, 2002
This article is the first to analyze the breakdown of income and expenditures of federal health c... more This article is the first to analyze the breakdown of income and expenditures of federal health care institutions belonging to various government agencies, in particular the federal clinics under the control of the Ministry of Public Health of Russia. It discusses possibilities of using the existing system of statistical and financial reporting to quantitatively evaluate the efficiency of budget funding of federal health care institutions. Institutional characteristics of the mechanism by which federal clinics are funded, including recent attempts to change it, are analyzed in detail. It is shown that the current mechanism provides for multi-level funding of the operation of federal clinics, perpetuates cost-based management, and is incompatible with the requirements of efficient use of resources. Recommendations are made for changing the budgeting procedure for funding of federal health care institutions' clinical activity.
We calculate electromagnetic and QCD isospin-breaking corrections to the energy level displacemen... more We calculate electromagnetic and QCD isospin-breaking corrections to the energy level displacement of the ground state of kaonic hydrogen. Our results, calculated within a quantum field theoretic and relativistic covariant approach, agree well with those obtained by Meißner, Raha and Rusetsky within the non-relativistic effective Lagrangian approach based on Chiral Perturbation Theory by Gasser and Leutwyler.
Social Aspects of Population Health, 2020
Семидесятая сессия Пункты 15 и 116 повестки дня 15-16301 (R) *1516301* Просьба отправить на втори... more Семидесятая сессия Пункты 15 и 116 повестки дня 15-16301 (R) *1516301* Просьба отправить на вторичную переработку Резолюция, принятая Генеральной Ассамблеей 25 сентября 2015 года [без передачи в главные комитеты (A/70/L.1)] 70/1. Преобразование нашего мира: Повестка дня в области устойчивого развития на период до 2030 года Генеральная Ассамблея принимает следующий итоговый документ саммита Организации Объединенных Наций по принятию повестки дня в области развития на период после 2015 года: Преобразование нашего мира: Повестка дня в области устойчивого развития на период до 2030 года Преамбула Настоящая Повестка дня-это план действий для людей, планеты и процветания. Она также направлена на укрепление всеобщего мира в условиях большей свободы. Мы признаем, что ликвидация нищеты во всех ее формах и проявлениях, включая крайнюю нищету, является важнейшей глобальной задачей и одним из необходимых условий устойчивого развития. Этот план будет осуществляться всеми странами и всеми заинтересованными сторонами, действующими в совместном партнерстве. Мы преисполнены решимости избавить человечество от тирании нищеты и нужды и исцелить и обезопасить нашу планету. Мы полны решимости предпринять смелые реформаторские шаги, которые настоятельно необходимы для того, чтобы вывести мир на траекторию устойчивого и жизнестойкого развития. Отправляясь в этот совместный путь, мы обещаем, что никто не будет забыт. Семнадцать целей в области устойчивого развития и 169 задач, которые мы объявляем сегодня, свидетельствуют о масштабности и амбициозности этой новой всеобщей повестки дня. Они предусматривают продолжение работы, начатой в период действия целей в области развития, сформулированных в Декларации тысячелетия, и окончательное достижение тех целей, которых не удалось достичь. Они предусматривают реализацию прав человека для всех и обеспечение гендерного равенства и расширение прав и возможностей всех женщин и девочек. Они носят комплексный и неделимый характер и обеспечивают сбалансированность всех трех компонентов устойчивого развития: экономического, социального и экологического. Эти цели и задачи будут стимулировать в ближайшие 15 лет деятельность в областях, имеющих огромное значение для человечества и планеты. Преобразование нашего мира: Повестка дня в области устойчивого развития на период до 2030 года A/RES/70/1
Profilakticheskaya meditsina, 2019
Несмотря на достигнутые в России успехи в области сокращения бремени неинфекционных заболеваний, ... more Несмотря на достигнутые в России успехи в области сокращения бремени неинфекционных заболеваний, уровень заболеваемости и преждевременной смертности в результате этих болезней остается достаточно высоким по сравнению с таковым в развитых странах. Свой вклад в снижение бремени может внести система экономических стимулов мотивации граждан к ведению здорового образа жизни, разработанная с учетом международного опыта использования таких механизмов. Цель исследования-на основе обобщения международного опыта разработать общие требования к дизайну комплексной системы экономических механизмов, направленных на изменение поведения людей в отношении их здоровья. Материал и методы. Системный поиск публикаций по разрабатываемому протоколу, комплексный анализ и систематизация полученной информации по применению экономических стимулов, направленных на изменение поведения людей в сфере здоровья. Результаты. В международной практике используется комплекс позитивных и негативных стимулов для изменения поведения людей в отношении своего здоровья. Ведущую роль в разработке экономических стимулов играют правительства. Существующая международная практика применения экономических механизмов влияния на поведение людей неоднозначна. Есть неудачные примеры реализации непродуманной фискальной стратегии. Разрабатываемая в России стратегия формирования здорового образа жизни должна в большей степени применять систему экономических стимулов, реализуемых разными заинтересованными сторонами, нацеленных на разные группы населения. Обобщенный международный опыт позволяет определить принципы, следование которым может способствовать разработке лучшей комплексной стратегии формирования здорового образа жизни. Выводы. Практика других стран демонстрирует необходимость комплексного подхода к формированию целостной системы экономических стимулов. Такая система предполагает учет интересов всех субъектов, ведущую роль правительства в разработке финансовых схем и механизмов, учет возможных положительных и отрицательных последствий ее введения. Ключевые слова: здоровый образ жизни, экономические механизмы, международный опыт.
Voprosy Ekonomiki, 2013
The private sector which has emerged in the Russian health care system has become a competitor to... more The private sector which has emerged in the Russian health care system has become a competitor to the public one and has pulled a part of effective demand of the middle class. It has developed out of the public health care financing system. Depending on the policy of the state towards modernization of health care, the private sector can continue to grow as an alternative to the public one, but it can be a tool of modernization and an organic part of an integrated health care system.
Health Economics, 2016
Global health spending share of low/middle income countries continues its long-term growth. BRICS... more Global health spending share of low/middle income countries continues its long-term growth. BRICS nations remain to be major drivers of such change since 1990s. Governmental, private and out-of-pocket health expenditures were analyzed based on WHO sources. Medium-term projections of national health spending to 2025 were provided based on macroeconomic budgetary excess growth model. In terms of per capita spending Russia was highest in 2013. India's health expenditure did not match overall economic growth and fell to slightly less than 4% of GDP. Up to 2025 China will achieve highest excess growth rate of 2% and increase its GDP% spent on health care from 5.4% in 2012 to 6.6% in 2025. Russia's spending will remain highest among BRICS in absolute per capita terms reaching net gain from $1523 PPP in 2012 to $2214 PPP in 2025. In spite of BRICS' diversity, all countries were able to significantly increase their investments in health care. The major setback was bold rise in out-of-pocket spending. Most of BRICS' growing share of global medical spending was heavily attributable to the overachievement of People's Republic of China. Such trend is highly likely to continue beyond 2025.
Journal of Health Politics Policy and Law
The reforms that have affected the Russian health care system since the breakup of the Soviet Uni... more The reforms that have affected the Russian health care system since the breakup of the Soviet Union, principally those in the general administration of the Russian Federation, have suffered from inconsistency and the absence of a strategy. The various reforms have caused a shift from a national health system characterized by highly centralized management and control, typical of the totalitarian uniform state, to a highly decentralized but fragmented multitude of state systems. Each of these systems is relatively centralized at the local level and run by local administrations with limited government infrastructure and experience. The role of government in the emerging system, and in particular the role of the federal government, remains ill defined. As a result, there is a grave risk that the Russian health care system may disintegrate as a national system. This undermines (a) the prevailing universal and fairly equitable access to care, (b) stabilization of the system following a lo...
Value in Health Regional Issues, 2014
To summarize results of studies that estimate the social costs of alcohol, tobacco, and illicit d... more To summarize results of studies that estimate the social costs of alcohol, tobacco, and illicit drug abuse in Russia. The purpose of these studies was to inform policymakers about the real economic burden of risky behaviors and to provide conditions for evidencebased and well-informed decision making in this area. Methods: The cost-of-illness method was applied to estimate the social cost of substance abuse. The intangible cost was not included in estimation. A prevalence-based approach was applied to estimate the tangible cost. For the estimation of direct costs, a top-down method was used. Indirect costs were estimated using two methods: the human capital and the friction cost. Results: In 2008, the social cost of substance abuse in Russia comprised 677.2 billion rubles if the friction cost method is applied and 1965.9 billion rubles if the human capital method is used. The social cost of substance abuse is defined to the greatest extent by alcohol consumption, comprising about 45% of the economic burden. Illicit drug use comprises about 30% of the economic burden and tobacco consumption 25%. Conclusions: The results of economic studies demonstrated that psychoactive substances impose a considerable economic burden on society. Analysis of the substance abuse social cost pattern shows that the main losses that society bears because of these behavioral risk factors fall outside the health care system and lay in other sectors of the economy such as social care, law enforcement, and productivity losses.
The Economics of Transition, 1996
In April 1993, the president of the Russian Federation signed an amended health insurance law (HI... more In April 1993, the president of the Russian Federation signed an amended health insurance law (HIL) designed to change fundamentally the structure of health system finance, organization. and management according to basic principles common to most OECD nations. The legislation provides for the separation of system functions as follows: a. funding of care; b. organization and management, or purchasing, of care through insurance companies" or sickness funds; and c. provision of care. While the first function remains primarily "public," so as to ensure universal access and equity, it is anticipated that the two' other functions, especially the third (provision of care), will eventually become decentralized and "non-governmental," possibly private, so as to promote production efficiency and client satisfaction. The separation of functions and the changes in ownership and management of care revolutionize the system. Nevertheless, despite the conceptually attractive features of the HIL, major issues remain to be addressed before successful implementation of the law can be achieved. These issues relate to the overall economic and institutional environment needed to support the legislation; policy-making and orientation of care; resource adequacy necessary for health objectives and equity: and denationalization of services. These issues should be addressed in conjunction with immediate measures needed to make the legislation operative, such as eligibility, relationship between social insurance and budgetary resources, and development budgets.
The International Journal of Health Planning and Management, 1997
The Russian (1993 amended) health insurance legislation initiated a far-reaching reform in the ®n... more The Russian (1993 amended) health insurance legislation initiated a far-reaching reform in the ®nancing, organization and management of the Russian health system. However, the implementation of the legislation has been slow and unstructured due to a lack of appropriate administrative and ®nancial mechanisms: these concern entitlement, private±public mix, ®nancial responsibilities of government at all levels, investment instruments, reimbursement and compensation systems, and a well-de®ned role of government. These issues are discussed in this article in the context of the Russian economy, the state of the health system, and the reform eort in the system. (&1997 John Wiley & Sons, Ltd.
MOCT-MOST Economic Policy in Transitional Economies, 1996
Journal of Health Politics, Policy and Law, 1999
The reforms that have affected the Russian health care system since the breakup of the Soviet Uni... more The reforms that have affected the Russian health care system since the breakup of the Soviet Union, principally those in the general administration of the Russian Federation, have suffered from inconsistency and the absence of a strategy. The various reforms have caused a shift from a national health system characterized by highly centralized management and control, typical of the totalitarian uniform state, to a highly decentralized but fragmented multitude of state systems. Each of these systems is relatively centralized at the local level and run by local administrations with limited government infrastructure and experience. The role of government in the emerging system, and in particular the role of the federal government, remains ill defined. As a result, there is a grave risk that the Russian health care system may disintegrate as a national system. This undermines (a) the prevailing universal and fairly equitable access to care, (b) stabilization of the system following a lo...
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Papers by Elena Potapchik