Shishkin S
Institute for Economy in Transition, Moscow 113546, Russia.
Croat Med J. 1998 Sep;39(3):298-307.
The introduction of health insurance system has been the core of the Russian health care reform. It has coincided with the decentralization of the state administration. The reform has thus been decentralized, and the transition has been fragmentary and incomplete. As a result, the existing health financing system is eclectic and contradictory. Meanwhile, the reform has had a positive stabilizing influence on financing of health care under conditions of continued economic crisis. The new priorities of the reform should be to balance the financial flows and the state's obligations, and to increase the efficiency of the use of resources through encouragement of competition, assurance of transparency of public funding, development of health care planning, and shift from inpatient to outpatient care.
医疗保险制度的引入一直是俄罗斯医疗改革的核心。这与国家行政管理的分权化同时发生。因此,改革呈现出分权化特点,转型过程零碎且不完整。结果,现有的医疗融资体系兼收并蓄且自相矛盾。与此同时,在持续的经济危机背景下,改革对医疗保健融资产生了积极的稳定影响。改革的新重点应是平衡资金流动和国家义务,通过鼓励竞争、确保公共资金的透明度、发展医疗保健规划以及从住院治疗转向门诊治疗来提高资源利用效率。