Things Can Only Get Better? Changing Views of the Past, Present and Future in the Former Soviet Union

Measurement of health system performance increasingly includes the views of healthcare users, yet little research has focussed on general population satisfaction with health systems. This study is the first to examine public satisfaction with health systems in the former Soviet Union (fSU). Data were derived from two related studies conducted in 2001 and 2010 in nine fSU countries, using nationally representative cross-sectional surveys. The prevalence of health system satisfaction in each country was compared for 2001 and 2010. Patterns of satisfaction were further examined by comparing satisfaction with the health system and other parts of the public sector, and the views of health care users and non-users. Potential determinants of population satisfaction were explored using logistic regression. For all countries combined, the level of satisfaction with health systems increased from 19.4% in 2001 to 40.6% in 2010, but varied considerably by country. Changes in satisfaction with the health system were similar to changes with the public sector, and non-users of healthcare were slightly more likely to report satisfaction than users. Characteristics associated with higher satisfaction include younger age, lower education, higher economic status, rural residency, better health status, and higher levels of political trust. Our results suggest that satisfaction can provide useful insight into public opinion on health system performance, particularly when used in conjunction with other subjective measures of satisfaction with government performance.

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Public satisfaction as a measure of health system performance: A study of nine countries in the former Soviet Union

Footman

et al. 2013

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Mental health inequalities in 9 former Soviet Union countries: Evidence from the previous decade

Goryakin

Suhrcke

Roberts

2015

Social Science & Medicine

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Compared with whom? Reference groups in socio-economic comparisons and self-reported health in 34 countries

Gugushvili¹,

Jarosz

McKee

2019

International Journal of Epidemiology

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Background The association between socio-economic position and health is believed to be mediated, in part, by psycho-social comparison of one’s situation with that of others. But with whom? Possibilities include family, friends, elites, or even those in other countries or in previous times. So far, there has been almost no research on whether the reference point matters. Methods We take advantage of a comparative data set that, uniquely, allows us to ask this question. The Life in Transition Survey was conducted in four Southern European and 30 Central and Eastern European and Eurasian countries. We sought differences in the probability of good self-reported health among those using different reference groups, including own family, friends and neighbours, domestic elites, people living in other countries and those living prior to a major politico-economic transition. We used multivariable and multilevel mixed-effects Poisson regressions and estimated treatment effects via the regression adjustment of Poisson models. Results In most cases the choice of reference group did not matter but in some it did. Among men in Eastern European and Eurasian societies, those who compared themselves with their parents and their own families before the start of transition were less likely to report good health compared with those who did not compare their own economic situation with any specific reference group. Conclusions For some individuals, the choice of who to compare one’s situation with does seem to matter, pointing to an area for future investigation in research on psycho-social determinants of health.

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Things Can Only Get Better? Changing Views of the Past, Present and Future in the Former Soviet Union

Cited by 3 publications

References 14 publications

Public satisfaction as a measure of health system performance: A study of nine countries in the former Soviet Union

Public satisfaction as a measure of health system performance: A study of nine countries in the former Soviet Union

Mental health inequalities in 9 former Soviet Union countries: Evidence from the previous decade

Compared with whom? Reference groups in socio-economic comparisons and self-reported health in 34 countries

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