DOI: 10.21045/2071-5021-2018-61-3-4

Kislitsyna O.A.
Federal State Institution of Science Institute of Economics of Russian Academy of Sciences, Moscow

Contacts: Kislitsyna O.A., email: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
Information about authors:
Kislitsyna O.A., http://orcid.org/0000-0002-4144-237X
Acknowledgments. The study had no sponsorship.
Conflict of interests. The authors declare no conflict of interest.

Abstract

Studies demonstrate that there are significant socioeconomic inequalities in access to health services in many countries. However, practically nothing is known about attitude of people towards such inequality.

The purpose of the study: to evaluate perception of social and economic inequality in healthcare by the Russian citizens; and to identify factors determining perception of injustice of inequality in healthcare and willingness of people to contribute to healthcare improvement for all.

The information base of the study was the International Social Survey program (ISSP), the 2011 round. Statistical analysis was conducted using the logistic regression model of the SPSS package.

The study shows that a significant share of the Russian citizens (67.7%) think it is not fair that people with higher income can afford better health care than people with lower income. However, people are reluctant to commit themselves to improve healthcare for all in the country; the share of those willing to contribute ads up to 14.6%.

People with low socioeconomic status, poor health, those who consider coverage with compulsory health insurance insufficient, people with children under 18 years of age, and people with radical political views are more likely to perceive injustice of inequity in access to health services. Willingness to pay higher taxes to improve healthcare for all is associated with other factors: old people, people with poor health, people with low education, low socioeconomic status, and the unemployed are less likely to contribute to healthcare improvement.

The results obtained help to conclude that further withdrawal of the State from the healthcare and expansion of payments for medical services can result in the growing public discontent.

Key words: inequality in access to health services; public opinion; perception of injustice.

References

1. Karaeva O.S. Predstavleniya o spravedlivosti i effektivnosti v sistemakh zdravookhraneniya razlichnykh stran (po dannym ISSP). [Ideas about equity and effectiveness of healthcare systems in different countries (according to ISSP)]. Vestnik obshchestvennogo mneniya. Dannye. Ànaliz. Diskussii 2014;1-2 (117). (In Russian).
2. Savel'eva ZH.V., Mukharyamova L.M., Kuznetsova I.B. Sotsial'naya spravedlivost' v zdravookhranenii: opyt i otsenki rossiyan [Social justice in health care: experience and assessments of Russians]. Mir Rossii 2018; 27(3): 154-179. (In Russian).
3. Abásolo I., Tsuchiya A. Egalitarianism and altruism in health: some evidence of their relationship. Int J Equity Health 2014; 13: 13. [Online]. 2014 [cited 2018 May 01]. Available from: https://equityhealthj.biomedcentral.com/articles/10.1186/1475-9276-13-13
4. Abásolo I., Tsuchiya A. Understanding preference for egalitarian policies in health: are age and sex determinants? Appl Econ 2008; 40: 2451-61.
5. Becker G. The Economic Approach to Human Behavior. Chicago, IL: The University of Chicago Press. 1976.
6. Damm K., Prenzler A., Zuchandke A. Does the perception of fairness and standard of care in the health system depend on the field of study? Results of an empirical analysis. BMC Health Serv Res 2014; 14: 166. [Online]. 2014 [cited 2018 May 01]. Available from: https://bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-14-166
7. Downs A. An Economic Theory of Democracy. New York: Harper and Row. 1957.
8. Evans D.B., Etienne C. Health systems financing and the path to univer­sal coverage. Bull World Health Organ 2010; 88: 402. [Online]. 2010 [cited 2018 May 01]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2878164/
9. Lee E-W., Park J-H. Egalitarian Health Policy Preference and Its Related Factors in Korea: National Representative Sample Survey. Korean Med Sci 2015; 30: 676-681.
10. Lynch J., Gollust S.E. Playing fair: fairness beliefs and health policy preferences in the United States. J Health Polit Policy Law 2010; 35: 849-87.
11. Missinne S., Meuleman B., Bracke P. The popular legitimacy of European healthcare systems: a multilevel analysis of 24 countries. Journal of European Social Policy 2013; 23: 231–247.
12. Mohseni M., Lindstrom M. Social capital, trust in the health-care system and self-rated health: the role of access to health care in a population-based study. Soc Sci Med 2007; 64: 1373–1383.
13. Reeves A., McKee M., Stuckler D. The attack on universal health coverage in Europe: recession, austerity and unmet needs. Eur J Public Health 2015; 25: 364–5.
14. von dem Knesebeck O., Vonneilich N., Kim T. J. Are health care inequalities unfair? A study on public attitudes in 23 countries. International Journal for Equity in Health 2016; 15: 61. [Online]. 2016 [cited 2018 May 01]. Available from: https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-016-0350-8

Write Comment

Please keep the topic of messages relevant to the subject of the article. Personal verbal attacks will be deleted. Please don't use comments to plug your web site. Such material will be removed. Just ensure to *Refresh* your browser for a new security code to be displayed prior to clicking on the 'Send' button. Keep in mind that the above process only applies if you simply entered the wrong security code.
Name:
E-mail
Comment:
Code:*