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

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  • 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.

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Bibliographic Info

Paper provided by Center for Economic and Financial Research (CEFIR) in its series Working Papers with number w0177.

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Length: 22 pages
Date of creation: Sep 2012
Date of revision:
Handle: RePEc:cfr:cefirw:w0177

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Related research

Keywords: social health insurance; infant mortality; under-five mortality; kernel regression; health care systems; health care quality; provider payment;

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  1. Cheng Hsiao & Qi Li & Jeff Racine, 2006. "A Consistent Model Specification Test with Mixed Discrete and Continuous Data," IEPR Working Papers, Institute of Economic Policy Research (IEPR) 06.47, Institute of Economic Policy Research (IEPR).
  2. Isabelle Joumard & Christophe André & Chantal Nicq, 2010. "Health Care Systems: Efficiency and Institutions," OECD Economics Department Working Papers 769, OECD Publishing.
  3. Racine, Jeff & Li, Qi, 2004. "Nonparametric estimation of regression functions with both categorical and continuous data," Journal of Econometrics, Elsevier, Elsevier, vol. 119(1), pages 99-130, March.
  4. Bidani, Benu & Ravallion, Martin, 1997. "Decomposing social indicators using distributional data," Journal of Econometrics, Elsevier, Elsevier, vol. 77(1), pages 125-139, March.
  5. 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 S221-S235.
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