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Urban inequity in the performance of social health insurance system: evidence from Russian regions

  • Galina Besstremyannaya



The paper assesses the impact of urbanization on the quality related outcomes of social health insurance systems in 85 Russian regions in 2000-2006. The results of parametric and kernel regressions reveal that controlling for regional income is a significant determinant of infant and under-five mortality. Arguably, the influence of urbanization on health outcomes is due to latent processes (e.g. the development of infrastructure). The methods of provider reimbursement are related to infant and under-five mortality, which offers suggestive evidence for selective contracting. Yet, insurer competition might increase urban inequity.

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Paper provided by Center for Economic and Financial Research (CEFIR) in its series Working Papers with number w0204.

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Length: 24 pages
Date of creation: Jan 2014
Date of revision:
Handle: RePEc:cfr:cefirw:w0204
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  1. 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.
  2. 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.
  3. Wagstaff, Adam & van Doorslaer, Eddy & Paci, Pierella, 1991. "Horizontal equity in the delivery of health care," Journal of Health Economics, Elsevier, vol. 10(2), pages 251-256, July.
  4. 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.
  5. 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.
  6. 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.
  7. 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.
  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. 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.
  10. Adam Wagstaff, 2010. "Social health insurance reexamined," Health Economics, John Wiley & Sons, Ltd., vol. 19(5), pages 503-517.
  11. Bidani, Benu & Ravallion, Martin, 1995. "Decomposing social indicators using distributional data," Policy Research Working Paper Series 1487, The World Bank.
  12. Wagstaff, Adam & van Doorslaer, Eddy & Paci, Pierella, 1991. "On the measurement of horizontal inequity in the delivery of health care," Journal of Health Economics, Elsevier, vol. 10(2), pages 169-205, July.
  13. Galina Besstremyannaya, 2012. "Estimating income equity in social health insurance system," Working Papers w0172, Center for Economic and Financial Research (CEFIR).
  14. Twigg, Judyth L., 1999. "Obligatory medical insurance in Russia: the participants' perspective," Social Science & Medicine, Elsevier, vol. 49(3), pages 371-382, August.
  15. Galina Besstremyannaya, 2009. "Increased Public Financing and Health Care Outcomes in Russia," Transition Studies Review, Springer, vol. 16(3), pages 723-734, October.
  16. 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.
  17. Culyer, A. J. & Wagstaff, Adam, 1993. "Equity and equality in health and health care," Journal of Health Economics, Elsevier, vol. 12(4), pages 431-457, December.
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