L.I. Menshikova^1,2, M.G. Dyachkova¹, E.A. Mordovsky^1
1 - NorthernStateMedicalUniversity (Arkhangelsk);
² - Ministry of Health of the Arkhangelsk region. 

Summary. Background. In 1990-2000 against the background of deep economic crisis the national healthcare system faced a problem of substantially increasing rates of fee-for service medicine for general population.

The aim of the study was to identify and quantify factors for out-of-pocket expenses on pharmaceuticals and medical services in the Arkhangelsk region.

Methods and data. Sociological survey of 1960 patients of health care facilities of the Arkhangelsk region. Cross-impact of factors affecting possible presence or absence of out-of-pocket expenses on pharmaceuticals and medical services among the respondents was evaluated using logistic regression analysis.

Results. The overwhelming majority of respondents (82.6%) incur expenses for pharmaceuticals and medical services regardless of gender and residence. The total median annual expences per one family member exceeded 6,000 rubles. It was found out that the set of factors accounting for the presence of out-of-pocket expenses on pharmaceuticals and medical services varies. Expenses on pharmaceuticals don’t depend upon health status. Factors related to performance of the regional healthcare system versus demographic and social and economic factors had but insignificant impact on presence of out-of-pocket expenses on pharmaceuticals and medical services among the respondents.

Scope of application. Conditions determining presence of out-of-pocket expenses on pharmaceuticals and medical services in the Arkhangelsk region were identified. Directions for care improvement for the population that are aimed at developing conditions for reduced rates of fee-for service medicine were specified.

Keywords. Medical care; pharmaceuticals; out-of-pocket expenses; factors determining presence of out-of-pocket expenses on pharmaceuticals and medical services

References

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