No abstract

The paper defines conditions to achieve the national goal of increasing the lifetime in the Russian Federation to 78 years by 2024 as set in Presidential Decree No. 204 of May 7, 2018. The measures proposed in the Healthcare and Demography national projects are analyzed and additional measures to improve public health are proposed. It is shown that because of inadequate government expenditures on medicines for outpatients, the financial burden of their acquisition by people is four times as much compared to the government spending. It was revealed that to achieve life expectancy of 78 years by 2024, the public healthcare per capita expenditures should grow by 15% annually in constant prices, providing that the country’s GRP per capita increases by 1.7% in 2019, by 3% in 2020 and by 4% in the period of 2021–2024, while the consumption of strong alcoholic beverages decreases by 45% per capita. In the Healthcare national project the healthcare expenditure growth rates are defined to be below 10% at current prices. The paper concludes that the achievement of this goal requires additional government expenditures (including those in the framework of the Healthcare national project). The funds should also be directed to expanding the availability of medicines for outpatients, programs for reducing mortality from infectious diseases, and increasing salaries of lower medical personnel. For the implementation of the Demography national project, particular targets should be set to reduce the alcohol consumption by 45% until 2024, with twofold reduction of the proportion of smokers, along with additional measures to implement the anti-alcohol and anti-tobacco policy and promote healthy living among the population.

Задача данного исследования – выявить социально-экономические и демографические факторы, а также характеристики системы здравоохранения и оперативные меры, принятые в борьбе с новой коронавирусной инфекцией COVID-19, которые способствовали скорейшей стабилизации эпидемической обстановки в разных странах. Для сравнения выбраны 14 стран: Белоруссия, Великобритания, Германия, Испания, Италия, Канада, Китай, Норвегия, Польша, США, Российская Федерация, Тайвань, Швеция и Южная Корея. Проведен анализ эпидемических (число выявленных случаев COVID-19 в расчете на 1 млн населения, летальность и смертность от этой инфекции на 100 тыс. населения, число проведенных диагностических тестов), демографических (средний возраст населения, плотность населения, ожидаемая продолжительность жизни – ОПЖ) и экономических (валовой внутренний продукт – ВВП на душу населения) показателей и оценено состояние системы здравоохранения (общие и государственные расходы на здравоохранение в процентах к  ВВП; обеспеченность стационарными койками и практикующими врачами; модель государственного финансирования здравоохранения и управления им). Показано, что главными факторами, способствующими успеху в борьбе с распространением новой коронавирусной инфекции COVID-19, являются раннее реагирование и решительные действия; централизация управления регионами и санитарно-эпидемиологической службой во главе с министром здравоохранения; наличие единой для страны стратегии действий; проведение массового тестирования и быстрое отслеживание контактов зараженных; централизованное распределение средств индивидуальной защиты, лекарств и других расходных материалов, а также мониторинг потребности в них; использование передовых информационных технологий; достаточные мощности системы здравоохранения (наличие резервного коечного фонда и медицинских кадров); ежедневная информационная работа с населением, которая осуществляется специалистами и министром здравоохранения.

No abstract

The article analyzes the dynamics of life expectancy (LE) in the Russian Federation over the past 40 years (from 1980 to 2020), the actual and projected Government spending on health care (2012-2024), identifies the conditions under which it is possible to achieve the national goal set in the Decree of the President of the Russian Federation of July 21, 2020 No. 474, to increase the life expectancy from 71.5 years in 2020 to 78 years by 2030. It is shown that in the Russian Federation from 1980 to 2019 life expectancy increased by only 5.6 years, and in 2019 it was 4.6 years lower than in the "new-8" EU countries, which are close to our country in terms of economic development, and 8.7 years lower than in the "old" EU countries. Government spending on health increased by only 33% in constant prices from 2012 to 2020, while it decreased by 4% from 2012 to 2018. The increase was provided in 2019 and 2020 due to the funds allocated additionally for the renewal of health infrastructure and fighting the pandemic. In the "new-8" EU countries, government spending on health care was 1.5 times higher, and in the "old" EU countries — 2.3 times more than in the Russian Federation. It has been established that in the Russian Federation, in order to achieve life expectancy of 78 years by 2030, it is necessary that the government spending on health care should grow by 8% annually at constant prices. These calculations are valid only if the following basic conditions are met: GDP per capita growth by 3.5-3.8% in the period 2021-2030, as well as decrease by 2030 in the consumption of strong alcoholic beverages by 45% per capita (without additional funds for fighting pandemic). This level of funding corresponds to 6.5 trillion rubles or 4.3% of GDP by2024. According to the projected public health expenditure for 2022-2024, these funds are not included in the budget. Thus, it will be impossible to solve the most acute problems of the health care system of the Russian Federation: to increase wages and eliminate the shortage of medical personnel, create a system of universal drug provision on an outpatient basis, increase the volume of free medical care, and, as a result, achieve the National Ggoal of increasing life expectancy.