Ludmila Maksimova, PhD «Center for Health Technology Assessment» PANEPA Executive Director of ISPOR Russia HTA Chapter

Transcription

1 CURRENT STATE OF HEALTHCARE FUNDING IN THE RUSSIAN FEDERATION: TRANSITION TO ONE-CHANNEL FUNDING ISPOR 17TH ANNUAL EUROPEAN CONGRESS 8-12 NOVEMBER 2014 AMSTERDAM RAI AMSTERDAM, THE NETHERLANDS Ludmila Maksimova, PhD «Center for Health Technology Assessment» PANEPA Executive Director of ISPOR Russia HTA Chapter

2 Russian HC funding: main features Increased 3 times in the last 15 years Continues to lack efficiency Funding standards do not correspond to the treatment standards State Guarantee Program is still unable to cover all core needs The role of out of pocket money in total funding is high Transferring to one-channel funding through OMI funds is not completed New advanced methods of HC funding HC based on DRGs are bring implemented The need for HTA is evident

3 Russian healthcare expenditures demonstrated significant and steady growth, but are still much less than in Europe Total healthcare expenditures % of GDP Per capita HC expenditures ($) Healthcare expenditures growth rates, % 2011 г г г. 21,1 19,1 14,1 12,5 11,4 11,3 9, ,3 7,3 6, ,2 Source: WHO

4 State Guarantees Program of Free Medical Care for : only 2,6 % of GDP Funding sources In BN % In BN % In BN % rubles Spending rubles growth rubles Consolidated 619,0 30,4 rates 647,9 will be 30,2 676,5 28,9 budgets of slowing down: the regions 5,3% in 2016 and OMI funds 1.414,2 69,6 9,4% 1.494,1 in , ,7 71,1 Total 2033, , ,2 100 % of GDP 2, Source: State Guarantees Program of Free medical assistance for

5 Per capita funding norms for medical care in State Guarantee Program (in Russian rubles) Average per capita funding norms for medical care in 2016 and 2017 will reach ,7 and ,6 (a little over 200 euros)

6 Healthcare spending lacks efficiency In terms of HC system efficiency Russia occupies the last 51st place lagging behind Brazil (50), Azerbaijan (49), Algeria (48), Columbia (47), Iran (46) и Belarus (43)* Bloomberg Most Efficient HC rating

7 Out of pocket spending ratio remains quite high Mandatory Medical Insurance Budget funds Voluntary health insurance Out of pocket spending Other Public Health Care - 61% Private Health Care 39% Source: Global Health Expenditure database, 2012

8 Flow of funds under current and onechannel funding models

9 Public HC funding structure: role of OMI funds is rapidly growing Federal Budget Treatment in special federal HC establishments Emergency and specialized care not covered by OMI (until 2015) High end HC in federal clinics ONLS and 7 HCD programs Vaccination Treatment in foreign clinics Medical Evacuation Regional Budgets Budgets Emergency care for not insured Psychiatry care, STD, TB, HIV, Hepatitis Regional pharmaceutical benefit program Drugs for orphan diseases Palliative care (from 2013) High end medical care in regional clinics OMI funds Primary care, disease prevention Annual health checks (from 2013) Emergency care (from 2013) Specialized care High end medical care (from 2015) In-patient drugs Assisted reproductive technology Medical rehabilitation

10 Healthcare funding structure in OMI budgets State budgets Under one-channel system OMI funds will cover the major part of medical care, primarily treatment of mass diseases. High cost and socially important treatments will continue to be covered from the budget funds. Budgets will also continue to cover expensive fixed capital and construction expenses.

11 # of beds (thousands) Hospital bed efficiency is growing Average length of treatment (days) Includes beds for non socially significant diseases # of days when the bed is occupied per year (days)

12 In-patient care optimization in regions Indicator 2012 (actual) 2013 (forecast) /2012 % # of hospitalizations # of hospitalization cases per one citizen 30,120,940 29,123,319 28,271,402 27,700, x # of beds (in thousands) Availability of beds per of people 1, , , ,

13 13 Оптимизация оказания МП в стационарных условиях в субъектах РФ

14 THANK YOU FOR YOUR ATTENTION «Center of Health Technology Assessment» PANEPA National Center of Health Technology Assessment Ludmila Maksimova +7 (916)