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Evaluation of health care delivery integration: The case of the Russian Federation

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  • Sheiman, Igor
  • Shevski, Vladimir

Abstract

Fragmentation in organization and discontinuities in the provision of medical care are problems in all health systems, whether it is the mixed public-private one in the USA, national health services in the UK, or insurance based one in Western Europe and Russia. In all of these countries a major challenge is to strengthen integration in order to enhance efficiency and health outcomes. This article assesses issues related to fragmentation and integration in conceptual terms and argues that key attributes of integration are teamwork, coordination and continuity of care. It then presents a summary of service integration problems in Russia and the results of a large survey of physicians concerning the attributes of integration. It is argued that characteristics of the national service delivery model don’t ensure integration. The Semashko model is not an equivalent to the integrated model. Big organizational forms of service provision, like polyclinics and integrated hospital-polyclinics, don’t have higher scores of integration indicators than smaller ones. Proposals to improve integration in Russia are presented with the focus on the regular evaluation of integration/fragmentation, regulation of integration activities, enhancing the role of PHC providers, economic incentives.

Suggested Citation

  • Sheiman, Igor & Shevski, Vladimir, 2014. "Evaluation of health care delivery integration: The case of the Russian Federation," Health Policy, Elsevier, vol. 115(2), pages 128-137.
    • Handle: RePEc:eee:hepoli:v:115:y:2014:i:2:p:128-137
    DOI: 10.1016/j.healthpol.2013.12.011
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    References listed on IDEAS

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    1. Valérie Paris & Marion Devaux & Lihan Wei, 2010. "Health Systems Institutional Characteristics: A Survey of 29 OECD Countries," OECD Health Working Papers 50, OECD Publishing.
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    Cited by:

    1. Igor M. Sheiman, 2014. "Integrated Health Care Payment Methods: Typology, Evidence And Pre-Conditions Of Implementation," HSE Working papers WP BRP 18/PA/2014, National Research University Higher School of Economics.
    2. Xin Yue & Kaining Mu & Lihang Liu, 2020. "Selection of Policy Instruments on Integrated Care in China: Based on Documents Content Analysis," IJERPH, MDPI, vol. 17(7), pages 1-17, March.
    3. Sergey Shishkin & Igor Sheiman & Vasily Vlassov & Elena Potapchik & Svetlana Sazhina, 2022. "Structural changes in the Russian health care system: do they match European trends?," Health Economics Review, Springer, vol. 12(1), pages 1-11, December.
    4. Daria Litvina & Anastasia Novkunskaya & Anna Temkina, 2019. "Multiple Vulnerabilities in Medical Settings: Invisible Suffering of Doctors," Societies, MDPI, vol. 10(1), pages 1-17, December.
    5. Igor Sheiman & Vladimir Shevski, 2017. "Two Models of Primary Health Care Development: Russia vs. Central and Eastern European Countries," HSE Working papers WP BRP 06/PSP/2017, National Research University Higher School of Economics.

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