Central Economics and Mathematics Institute of the Russian Academy of Sciences, Moscow, Russia.
J Health Organ Manag. 2009;23(5):465-76. doi: 10.1108/14777260910983970.
The drug benefit reform implemented in Russia in 2005 allowed benefit groups to choose between the fixed monetary compensation or the in-kind benefits. This paper seeks to study the efficiency of the in-kind drug benefit system before and after the reform by comparing mandated groups of monetary savings within each of the schemes.
DESIGN/METHODOLOGY/APPROACH: Pair-wise correlation analysis using the Federal Social Insurance Fund benefit groups database (85 regions in 2005-2006) and two representative consumer expenditure surveys: the National Assessment of Population Welfare and Participation in Social Programs: NOBUS (47 regions, over 40,000 households, 2003) and the Russia Longitudinal Monitoring Survey: RLMS (32 regions, over 4000 households, 2003).
The paper finds that giving the mandated population a choice between the two schemes led to an increase in demand for drugs and adverse selection within the in-kind drug provision system.
RESEARCH LIMITATIONS/IMPLICATIONS: The Federal Social Insurance Fund aggregated data allow one to make post-reform estimations only for an average representative of a certain benefit group. Employing micro data on both pre- and post-reform consumer behavior would become a tool for more precise econometric analysis.
The results of the correlation analysis demonstrate an imbalance in the solidarity principle and the need for introducing health and drug insurance mechanisms in the Russian drug benefit programme.
ORIGINALITY/VALUE: The paper represents an attempt to use a large sample statistical analysis along with the Federal Social Insurance Fund data in order to assess drug benefit groups of behavior in Russian regions before and after the drug benefit reform.
2005 年俄罗斯实施的药品福利改革允许受益群体在固定货币补偿或实物福利之间进行选择。本文旨在通过比较每个方案中规定的货币节省强制性群体,来研究改革前后实物药品福利制度的效率。
设计/方法/途径:使用联邦社会保险基金福利群体数据库(2005-2006 年的 85 个地区)和两个有代表性的消费者支出调查:国家人口福利和参与社会计划评估:NOBUS(47 个地区,超过 40000 户家庭,2003 年)和俄罗斯纵向监测调查:RLMS(32 个地区,超过 4000 户家庭,2003 年)进行成对相关分析。
本文发现,让强制性人口在两种方案之间进行选择,导致对药品的需求增加,并在实物药品供应系统中出现逆向选择。
研究局限性/影响:联邦社会保险基金汇总数据仅允许对特定福利群体的平均代表进行改革后估计。使用改革前后消费者行为的微观数据将成为更精确的计量经济学分析的工具。
相关分析的结果表明,团结原则存在不平衡,俄罗斯药品福利计划需要引入健康和药品保险机制。
原创性/价值:本文代表了一种尝试,即使用大样本统计分析以及联邦社会保险基金数据,以评估俄罗斯地区药品福利改革前后药品福利群体的行为。