IDEAS home Printed from https://ideas.repec.org/p/hig/wpaper/07-pa-2013.html
   My bibliography  Save this paper

Adopting new medical technologies in Russian public hospitals: what causes inefficiency?

Author

Listed:
  • Liudmila Zasimova

    () (National Research University Higher School of Economics, Laboratory for Economic Research in Public Sector, deputy head)

  • Sergey Shishkin

    () (National Research University Higher School of Economics, Institute of Health Economics, research supervisor)

Abstract

The adoption of new medical technologies in Russian public hospitals is an important part of healthcare modernization and thus is a subject for public finance and regulation. Here we examine the decision-making process on adoption of new technologies in Russian hospitals, and the institutional environment in which they are made. We find that public hospitals operate within a strategic-institutional model of decision making and tend to adopt technologies that bring indirect benefits to their heads/physicians. Unlike Western clinics, the interests of Russian hospital heads and physicians are driven by the possibilities to obtain income from a part of hospital activities: the provision of chargeable medical services to the population, as well as receiving informal payments from patients. The specifically Russian feature of the decision-making process is that hospitals are strongly dependent on health authorities’ decisions about new equipment acquisition. The inefficiency problems arise from the contradiction between hospitals’ and authorities’ financial motivation for acquiring new technologies: hospitals tend to adopt technologies that bring benefits to their heads/physicians and minimize maintenance and servicing costs, while authorities’ main concern is initial cost of technology. The main reason for inefficiency of medical technology adoption arises from centralization of procurement of medical equipment for hospitals that creates the preconditions for rent-seeking behaviour of persons making such decisions

Suggested Citation

  • Liudmila Zasimova & Sergey Shishkin, 2013. "Adopting new medical technologies in Russian public hospitals: what causes inefficiency?," HSE Working papers WP BRP 07/PA/2013, National Research University Higher School of Economics.
  • Handle: RePEc:hig:wpaper:07/pa/2013
    as

    Download full text from publisher

    File URL: http://www.hse.ru/data/2013/11/25/1336945889/07PA2013.pdf
    Download Restriction: no

    References listed on IDEAS

    as
    1. Danzon, Patricia Munch, 1982. "Hospital `profits' : The effects of reimbursement policies," Journal of Health Economics, Elsevier, vol. 1(1), pages 29-52, May.
    2. Greer, Ann Lennarson, 1984. "Medical technology and professional dominance theory," Social Science & Medicine, Elsevier, vol. 18(10), pages 809-817, January.
    3. Feldstein, Martin S, 1971. "Hospital Cost Inflation: A Study of Nonprofit Price Dynamics," American Economic Review, American Economic Association, vol. 61(5), pages 853-872, December.
    Full references (including those not matched with items on IDEAS)

    More about this item

    Keywords

    medical technology; adoption; public hospital; Russia; causes of inefficiency;

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:hig:wpaper:07/pa/2013. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Shamil Abdulaev) or (Victoria Elkina). General contact details of provider: http://edirc.repec.org/data/hsecoru.html .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.