Akhmetzyanov A.R.
“Higher School of Economics” National Research University, Moscow
Abstract. The article addresses major problems related to the
improvement of primary care remuneration system in the Russian
regions. Significance of the topic is determined by the need of
transition towards predominantly per capita remuneration in accordance
with the federal legislation in the context of unavailability of the
specific methodology of medical care remuneration system under the new
circumstances.
The purpose of the study was to analyze major
inconsistencies of implementing the per capita primary care remuneration
model in the Russian Federation due to lack of coordination between
care organization and care remuneration in terms of incentives for care
providers.
Methods: statistical data analysis and comparison
method with the use of materials on healthcare systems of the 18
European countries and the Russian Federation.
The analysis results show that the existing characteristics of
healthcare organization in our country contribute to insufficient
realization of the incentives component of per capita primary care
remuneration model.
As a means to address the existing inconsistencies it is suggested to
follow a step-wise transition towards evaluation of care providers’
performance based on pay-for-performance model, as well as to create
conditions for eliminating staff deficit or optimizing workflow of the
existing health services.
Keywords. Per capita remuneration; primary health care; pay-for-performance model; ongoing stimulation; effective contract.
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