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The impact of private health insurers on the quality of Russian regional health systems

Author

Listed:
  • Galina Besstremyannaya

    (Center for Economic and Financial Research at New Economic School)

  • Jaak Simm

    (Tokyo Institute of Technology, Graduate School of Information Science and Engineering)

Abstract

The 1991 law ‘On health insurance for the citizens of the Russian Federation’ established that social health insurance is to be offered by multiple private insurance companies. The paper is the first econometric analysis measuring the effect of private health insurers on quality related outcomes of social health insurance (SHI) systems in Russian regions. The baseline model introduces regional SHI system as a binary variable with unity value corresponding to the presence of private health insurers as the only agents at the SHI market. The extended model captures endogeneity by employing an instrumental variable approach. The non-parametric model uses kernel regressions. The results of parametric and kernel regressions reveal that the presence of private insurers is a significant determinant of infant and under-five mortality. The positive impact of private insurers is explained by regional institutional reforms. The methods of provider reimbursement are related to infant and under-five mortality, which offers suggestive evidence for enabling insurer competition through selective contracting with health care providers.

Suggested Citation

  • Galina Besstremyannaya & Jaak Simm, 2012. "The impact of private health insurers on the quality of Russian regional health systems," Working Papers w0177, New Economic School (NES).
    • Handle: RePEc:abo:neswpt:w0177
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    File URL: https://www.nes.ru/files/Preprints-resh/WP-177.pdf
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    References listed on IDEAS

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    1. Margaret M. Byrne & Kenneth Pietz & LeChauncy Woodard & Laura A. Petersen, 2007. "Health care funding levels and patient outcomes: a national study," Health Economics, John Wiley & Sons, Ltd., vol. 16(4), pages 385-393, April.
    2. Twigg, Judyth L., 1999. "Obligatory medical insurance in Russia: the participants' perspective," Social Science & Medicine, Elsevier, vol. 49(3), pages 371-382, August.
    3. Sudhir Anand & Martin Ravallion, 1993. "Human Development in Poor Countries: On the Role of Private Incomes and Public Services," Journal of Economic Perspectives, American Economic Association, vol. 7(1), pages 133-150, Winter.
    4. Adam Wagstaff, 2010. "Social health insurance reexamined," Health Economics, John Wiley & Sons, Ltd., vol. 19(5), pages 503-517, May.
    5. Judyth Twigg, 1998. "Balancing the state and the market: Russia's adoption of obligatory medical insurance," Europe-Asia Studies, Taylor & Francis Journals, vol. 50(4), pages 583-602.
    6. Bidani, Benu & Ravallion, Martin, 1997. "Decomposing social indicators using distributional data," Journal of Econometrics, Elsevier, vol. 77(1), pages 125-139, March.
    7. Adam Wagstaff & Mariam Claeson, 2004. "The Millennium Development Goals for Health : Rising to the Challenges," World Bank Publications - Books, The World Bank Group, number 14954, December.
    8. Sheiman, Igor, 1994. "Forming the system of health insurance in the Russian Federation," Social Science & Medicine, Elsevier, vol. 39(10), pages 1425-1432, November.
    9. Racine, Jeff & Li, Qi, 2004. "Nonparametric estimation of regression functions with both categorical and continuous data," Journal of Econometrics, Elsevier, vol. 119(1), pages 99-130, March.
    10. Filmer, Deon & Pritchett, Lant, 1999. "The impact of public spending on health: does money matter?," Social Science & Medicine, Elsevier, vol. 49(10), pages 1309-1323, November.
    11. Office of Health Economics, 2007. "The Economics of Health Care," For School 001490, Office of Health Economics.
    12. Sheiman, Igor, 1991. "Health care reform in the Russian Federation," Health Policy, Elsevier, vol. 19(1), pages 45-54, September.
    13. James H. Stock & Motohiro Yogo, 2002. "Testing for Weak Instruments in Linear IV Regression," NBER Technical Working Papers 0284, National Bureau of Economic Research, Inc.
    14. Douglas Staiger & James H. Stock, 1997. "Instrumental Variables Regression with Weak Instruments," Econometrica, Econometric Society, vol. 65(3), pages 557-586, May.
    15. Curtis, Sarah & Petukhova, Natasha & Taket, Ann, 1995. "Health care reforms in Russia: The example of St Petersburg," Social Science & Medicine, Elsevier, vol. 40(6), pages 755-765, March.
    16. Burger Jr., E.J. & Field, M.G. & Twigg, J.L., 1998. "From assurance to insurance in Russian Health Care: The Problematic transition," American Journal of Public Health, American Public Health Association, vol. 88(5), pages 755-758.
    17. Guillem Lopez‐Casasnovas & Joan Costa‐Font & Ivan Planas, 2005. "Diversity and regional inequalities in the Spanish ‘system of health care services’," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages 221-235, September.
    18. Ivaschenko, Oleksiy, 2005. "The patterns and determinants of longevity in Russia's regions: Evidence from panel data," Journal of Comparative Economics, Elsevier, vol. 33(4), pages 788-813, December.
    19. Andrew M. Jones (ed.), 2006. "The Elgar Companion to Health Economics," Books, Edward Elgar Publishing, number 3572.
    20. Hayfield, Tristen & Racine, Jeffrey S., 2008. "Nonparametric Econometrics: The np Package," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 27(i05).
    21. Hsiao, Cheng & Li, Qi & Racine, Jeffrey S., 2007. "A consistent model specification test with mixed discrete and continuous data," Journal of Econometrics, Elsevier, vol. 140(2), pages 802-826, October.
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    More about this item

    Keywords

    social health insurance; infant mortality; under-five mortality; kernel regression; health care systems; health care quality; provider payment;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • G22 - Financial Economics - - Financial Institutions and Services - - - Insurance; Insurance Companies; Actuarial Studies
    • R22 - Urban, Rural, Regional, Real Estate, and Transportation Economics - - Household Analysis - - - Other Demand

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