Maximum Waiting Times Guarantee In Russia: Does It Improve Access To Health Care?

The objective of the paper is to explore the role of maximum waiting times targets in improving access to health care in the context of the country with limited financial resources. The study indicates that most of targets in Russia are unrealistically low, while institutional and operational arrangements for their implementation have not been built. Some regions of the country have started waiting times monitoring, but its coverage of providers is still limited. The estimates of actual waiting times are fragmented and unreliable. The lack of waiting time regulation and monitoring encourages the opportunistic behavior of health providers to meet the targets. Uncertainty of patients regarding actual waits is growing. Thus a waiting times guarantee is not a remedy to avoid excessive waiting times. To make it really work, we recommend: 1) to develop realistic targets of waiting times that are based on a careful evaluation of the actual indicators for each type of care, as well as the capacity to meet them; 2) to strengthen waiting time monitoring, including pooling waiting lists/waiting times information in centralized information systems, introducing a unified pattern of waiting data reporting with the clarity on the initial point of waiting times, measuring both completed and on-going waits; 3) to build accountability procedures with the involvement of all actors of health care system.