Perspectives of private health service development in rural regions (basing on the results of Perm experiment)

The article presents an analysis of the intermediate results of the pilot project on the private health care development at the level of first-aid medical posts. The project is being realized in the region of Perm. The initial goal of the experiment was to solve the problem of creating a competitive environment in the health care sphere in Russia and the ultimate one was to improve the quality of medical service and the health of population.Case study of 12 private medical practices in January-March 2012 identified the following problems: low rates in the system of CMI; loss of benefits; difficulties in accounting and reporting; the heavy workload and the shortage of staff; the high cost of the equipment; a negative attitude of the local population; penalty sanctions as a result of the audit bodies inspections.Conclusion: the initial hypothesis, that the participants of the project have leadership skills, the propensity to risk and strategic vision, has not been confirmed, since many of them had to take part in the project. It has been found that those medical organizations that are located on the territories with big population, with working people prevailing, and, consequently, with a lot of children, have the best perspectives for development. Close contacts with the hospital management and local authorities increase chances for them to survive and develop.In conclusion the article gives recommendations for strengthening the financial stability of private medical practices, for motivating doctors-entrepreneurs and for solving the staff problem.