Russian Healthcare Structure Overview and statistics

Russian Healthcare system is known to be flawed and its standards are well under the Western medical standards. The backbone of the Russian Healthcare system has been developed before the 1990s, when it had under control the medical situation of the whole country. After the fall of the Soviet Union, the states that now form the Russian Federation, including Russia still find it difficult to improve the quality of their medical services.

Theoretically, every Russian has access to the public healthcare services as they are all entitled to the Obligatory Medical Insurance, which consists of  2% to 3% of the wage and is deducted by employers into a social tax that ends up in the Russian Healthcare Fund. Practically, due to lack of funding of the medical sector, the compulsory insurance does not cover most of the treatments and the patients have to pay from their own pockets for all the medical services they have been provided with, unless in case of emergency when an ambulance is needed. Moreover, due to the high prices of private insurance and the low incomes households have, only around 5% of Russians subscribe to the Voluntary Health Insurance, as well, in order to get more control over their medical treatment by choosing the hospital or clinic where to perform it, and by shortening the waiting times. The prices for the Voluntary Health Insurance vary from 135 USD to 610 USD per month, while the average Russian household monthly income is 320 USD.

According to information from the Organisation for Economic Co-operation and Development,  in 2012, the Russian Federation had 4.9 doctors and 7.5 nurses per 1000 people. The number of doctors is higher than OECD countries’ average number of only 3.2, while the number of nurses is under the OECD countries’ average of just 8.8. Russia’s number of hospital beds per 1000 people has fallen from 11.4 in 2000 to 9.3 in 2012, which is almost twice the average number of beds of OECD member countries have, respectively 4.8, even with a higher number of doctors and hospital beds, the Russian healthcare system still does not respond to the needs of the patients.

According to WHO (World Health Organisation), in terms of psychiatric facilities, there are only 8.4 psychiatrists, 2.4 social workers and 4.6 psychologists per 100.000 people.

More facts about Russian healthcare system              

In Russia, the actual health expenditure from GDP is at 5.3%, which is lower than the health expenditures from GDP South American and African countries have.

Russia has a population of more than 145 million people and 72.9% out of them live in the urban areas. Considering Russia’s vast territory and harsh climate in some of its areas, some of its citizens live in areas with limited access to medical services.

Beside, the major cities, such as Moscow and Sankt Petersburg, where the healthcare facilities overrun all the other healthcare facilities from the rest of the country and some of them are even listed in world top rankings, such as Moscow’s Children Hospital on the 250th place and Bakulev Center for Cardiovascular Surgery on the 291st place. Usually, the hospitals are outdated, the doctors are unwilling to adapt to the current medical trends and to improve the patient-doctor encounters and treatments.

In most cases, doctors do not share details about the treatment with their patients, there is no shared decision making between the healthcare professional and the patient and there are no disclosures in regards to the treatment path. The medical team uses out-dated techniques for diagnosis, treatment and patient communication, and therefore it is unable to provide patients with a satisfactory experience. Additionally, 26% of the Russians claim that they have bribed the medical staff in order to obtain access to basic treatments and to shorten the waiting times. Studies show that both doctors and nurses have monthly salaries as low as 250 USD.

Due to lack of funding into the medical sector, more than 17.500 villages and towns have no medical infrastructure at all. Throughout Russia, there are public facilities that are controlled by the Russian Ministry of Health which lack sewerage and hot water, negatively impacting the quality levels of care. The lack of telephone connections has significant implications for the development and maintenance of information systems. Those facilities most likely to lack such basic services are predominantly in rural areas, where few other buildings locally would have access to such services either.

For years now, there have been continuous drug shortages. In Russia, there are approximately 17.000 pharmacies. Only 17% of them are privately owned, while the rest is controlled by each region’s authority. The pharmacies controlled by the state’s authorities have failed to deliver hospitals with basic drugs such as glucose, Prednisone or Lamivudine, due to the high levels of corruption.

Russia is one of the few countries where life expectancy is declining. Studies show that life expectancy among Russians is only 74 years. In 2018, life expectancy for women was 77.8 years while for men it was just 66.3 years.

The main three causes of the continuously declining life expectancy among Russians are Cardiovascular diseases, cancer (lung cancer is one of the deadliest among Russians, considering the alarming rate of smokers) and external causes (including injuries and poisonings). Data shows that between 2002 and 2005, 61.3% of men were smoking, while only 15% of women had this habit. Although noncommunicable diseases account for the vast majority of mortality and morbidity in the Russian Federation, communicable diseases also pose a serious threat to population health.

Russian patients seeking for treatments abroad

Data shows that annually, more than 70.000 Russians choose to travel abroad, in order to get better healthcare services than they would receive at home, services of which they are not satisfied at all with.

Taking into account the fact that the Russian economy is growing, the middle and upper class have more money available to improve both their health and wellbeing. Russians that are affording healthcare services abroad are looking to pay more for these services, only to be treated professionally.

According to the International Medical Travel Journal, an interview performed on 428 Russians showed that 52%  want to travel abroad and seek higher quality of medical treatments and services, 65%  of them are traveling for a period of time between 2 to 6 months.

The most common reasons behind the medical trips that the interviewed Russians have: are getting higher quality of services and treatments (52%),  combine the treatment with recuperation (29%), reduce costs (14%) and due to the fact that they have not been able to obtain a suitable treatment in their country (5%).

Germany is the top destination among Russians for healthcare services (29%). Other popular countries for medical tourism among Russians favourites are Israel (22%), Spain (6%), China (6%), UK (5%), South Korea (4%), Japan (4%), India (4%), Cyprus (4%), Switzerland (4%), Hungary (4%), USA (3%), Austria (3%) and Thailand (2%).

The medical services that the interviewed Russians are looking for abroad are to seek specific diagnosis and subsequent treatment in 37%. Others, 21%, have already been diagnosed and are looking to get surgery. 21% of them are looking for plastic surgeries, while only 13% are seeking dental care.

 In terms of their financial possibilities, 58% of Russians are prepared to pay between 10.000 Euros to 25.000 Euros for a medical trip 39% believe that their abroad healthcare treatments should not surpass the amount of 10.000 Euros and only 3% are prepared to spend more than 25.000 Euros.

Conclusion

As the Russian medical sector is well unfunded, the lack of defined federal and local health protection policies, or effective programs aiming to monitor the results or the lack of the control systems and delegation of responsibilities for the state structures have pushed Russians to spend more than 1.4 billion USD annually on medical healthcare services abroad. The nation’s need to improve its healthcare facilities is urging patients to consider treatment options abroad. Russia is then becoming one of the most important customers of medical tourism.