On reforming the remuneration system in health care: achievements, challenges, adjustments

The article studies the problem of the effective remuneration system development in healthcare. The remuneration system of the state (municipal) health care institutions has been reformed twice. Today, a new stage is being started, which is caused by a number of unsettled questions (such as a lack of unified approaches to salary regulation, large inter-and intra-regional differentiation) and new challenges (pandemic after-effects). Purpose: to consider main stages of the remuneration system reforming in health care institutions of the Russian Federation; to characterize the reform content, achieved results and current problems, to give an opinion. Results: 1. The author analyzes the problems associated with achievement of the target indicators on medical personnel salaries, and provides an explanation. 2. The author reveals the factors reducing efficiency of the existing remuneration system: economic (funding level of the institutions), managerial (high degree of autonomy of heads of the institutions in administering funds) and organizational (absence of transparent techniques of personnel assessment and motivation). 3. The author suggests correcting the target indicators on medical personnel salaries in line with the average salaries of strategic enterprises employees; not to include the stimulating payments in the amount of the minimal salary. The article contains data of the Federal statistical observation of the remuneration in healthcare for the 2013-2019 years; specifies calculation methods of basic indicators; observes the relevant legislative acts, including the newest ones.