Yi.A. Geht¹, G.B. Artemyeva^2
1Samara State Medical University, Samara
²Territorial Mandatory Medical Insurance Fund of the Ryazan region, Ryazan

The resume. Peculiarities of medical and demographic development of the country form the base for evaluation of population demand for medical care and its resources. Current demographic tendencies in the vast majority of regions of Russian Federation include evident population ageing. The Law of the RF: “On mandatory medical insurance in the Russian Federation” provides significant expansion of citizen’s rights in mandatory medical insurance. In particular, citizens have acquired the right to choose medical insurance company and healthcare organization. Age structure of the population covered by the organizations in the system of mandatory medical insurance largely affected their grade of financial sustainability and economic welfare. Working population were scarce or nearly none in this structure which implied domination of retired population, then the latter became main consumers of medical services to be rendered to the population. Such situation factually denied the principle of solidarity of financial responsibility, which in turn negatively affected the issue of payments for medical care along per capita schemes with the use of fundholding elements. In tackling the issues of medical access of old and elderly people, it was found only reasonable to stick to their local dependence in outpatient care and admission to a hospital implying rigid reference schemes. A switch-over to single-channel financing of healthcare (where all funding should go from the resources of the mandatory medical insurance) has urged taking into account the peculiarities of rendering emergency and the rest of medical care to the elderly people with certain implications for specific approaches to the procedure and concrete ways of payments for medical care rendered to such people. Population ageing of the population necessitated reconsideration of the existing procedure of organization of medical care in medical establishments incorporated in the mandatory medical insurance.

Key words. Population ageing; demography; per capita funding; single channel funding.

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