According to the study “health of the future” (Future Health Index), health workers and the population appreciate the availability of health below (58.0 points) than it is in reality (compared to 68.1 points). Do not trust the domestic health care system, and the Russians on other issues.
The uniqueness of the study “health of the future”1 is that it compares the perception of health systems worldwide with the objective indicators of the actual state of the industry. The findings of the study in 2017 based on responses from 891 3 specialist and 29 410 ordinary citizens from 19 countries (including Brazil, China, Germany, Singapore, UAE, UK and USA). In our country, the sociologists interviewed Philips 680 ordinary citizens and more than 200 health workers. The control data about the actual situations provided the who, the world Bank and the International Data Corporation (IDC).
The study showed that less than half of Russians (48%) trust the domestic health care system. By the way, the same pattern in some very wealthy countries where the actual availability of medical care is high, but the public often underestimates their healthcare. For example, in Sweden, where there is no shortage of qualified specialists, no risk to fail because of the need to pay for the surgery, the perception of accessibility is lagging behind the real situation on 16 points. Just less than half (48%) of Swedes agree with the statement that they have access to all the necessary procedures for the prevention and treatment of diseases.
But in China, where very high confidence in the health system, the availability of medicine is significantly overvalued. For example, the share of skilled workers among the population in China is only 31.5 per specialist per 10,000 people is lower than in all other countries where the study was conducted by Philips (42,7).2
Index data the health of the future revealed another problem of the Russian healthcare system, which makes it ineffective. And probably also affects the citizens ‘ perception of availability of medical care. We are talking about a weak integration, which means that all parts of the system (doctors, nurses, patients, hospitals, insurance companies and government agencies) are maximally coordinated. For example, data is exchanged between medical examinations, including using it systems, and agree on treatment plans. Another sign of integration of care – relationship of its main stages (prevention, diagnosis, treatment and rehabilitation).
In the opinion of the respondents to the questionnaires Philips Russian doctors, better medical care is also impeded by the shortage of qualified personnel and a complete lack of connection between the public sector and the private sector. And, although the majority of Russians (60%) and health workers (80%) believe that today the Russian health care system cannot be called integrated, since this sector is still heavily overvalued. Real integration index lower than the perceived population of 44 points and is only 6 units is one of the worst results among the 19 countries in which the study was conducted.
Meanwhile, according to the study, in Russia, 96% of the responders evaluate the state of health of the population as “poor” or “unsatisfactory”. Citizens, however, are more optimistic, but 56% of them still agree with the doctors.
Another part of the study Philips for the efficiency of national health systems. When calculating the efficiency factor was taken into account, the average life expectancy in the country, maternal and infant mortality and mortality from non-communicable diseases and how much money (percent of GDP) the government spends on health care. The ranking is in 2017, with coefficients of 22.7 and 18.1, respectively, the United Arab Emirates and Singapore.3 Least effective recognized by the South African health system with a factor of 4.4.
The effectiveness of Russian health care is not very high (9.6 points). According to who and Bank data from Global health Observatory, average life expectancy in our country is 70.5 years (of healthy life to 68.3). And the main cause of death are diseases of the cardiovascular system. The actual value of public expenditure on health care in Russia in 2014 amounted to 7.1% of GDP.4 Although the Russians themselves, who participated in the study “health of the future”, I believe that this figure should be higher – not less than 22% of the state budget.
The study showed that the absolute value of expenditure on health does not correlate directly with the effectiveness of the system. So, in this ranking, Germany, Sweden and France were lower than in Russia. And the United States, invest in the medicine 17.1% of GDP, generally took the penultimate place. That is, even though these countries manage to achieve very good results (for example, in Sweden the overall performance of the health system is 91.2 per cent against 68.2 per Russian), this is achieved only by the same high costs.
In Russia in the short term, increases in government spending on health care is not expected. But our country has other reserves: according to experts Philips, improve efficiency of health will allow the passage of medical care using telemedicine, and also focus on prevention.
Today in Russia there are free preventive tests, but that’s not enough, experts say Philips is a serious socially significant diseases require more thorough diagnostics. More than 62% of Russian physicians also believe that the emphasis in their work needs to be done on prevention. However, according to them, only 38% of the population – the majority of citizens a priority still treatment of disease. “Many Russians underestimate the importance of prevention and do not notice deterioration in their health until faced with a specific diagnosis. And this speaks to the need to raise citizens ‘ awareness about the importance of prevention and promotion of healthy lifestyle… People need to feel that they play an active role in taking care of your health,” conclude the authors of the study “the index of the health of the future.”