2023 № 2 Subsidized Pharmaceutical Provision for patients in the Federal Districts and subjects of the Russian Federation using the example of the most common diseases.
In the Russian Federation, the obligations of federal and regional authorities for Subsidized Pharmaceutical Provisionfor patients are legally defined, the issues of providing patients with drugs for the treatment of a particular nosology are analyzed with varying degree of detail, however, a comprehensive assessment of Subsidized Pharmaceutical Provision for patients with the most common diseases in the Federal Districts and federal subjects was not carried out. This was the aim of this study. We analyzed the purchase of medicines for the treatment of patients with cancer, broncho-obstructive diseases (bronchial asthma and chronic obstructive pulmonary disease) and diabetes in the Federal Districts and federal subjects of Russia though regional and federal budgeting and recalculated the total spendings per 1 patient living in the Federal District or federal subject.
We found that both the federal districts and the constituent entities differed in the budget spendings for purchase of medicines for the treatment of the analyzed nosologies. In addition, we found inconsistency in the sum of funds spent on the subsidized Pharmaceutical Provision from year to year.
The availability of medicines at the outpatient stage of treatment of cancer, broncho-obstructive diseases and diabetes mellitus differs greatly between the different Federal Districts and on the federal subject level. This creates unequal access to drug treatment for patients at the outpatient stage of treatment. Health authorities do not use a unified methodology for planning the demand of medicines at the outpatient stage of treatment, nor a unified strategy for Subsidized Pharmaceutical Provision xecution.
2023 № 1 Planning medical care for patients with cancer in the constituent entities of the Russian Federation.
National project “Fight against oncological diseases 2019 - 2024” implemented for the fourth year. During this time, experience has been gained in planning the volume of medical care, including diagnostic tests, and financial support in the system of compulsory medical insurance, but there is no systematic analysis of planning problems. The purpose of this study was to study the planning by the subjects of the volume of medical care and their implementation of the target indicators of the territorial programs of state guarantees of free medical care (TPGG) and to identify planning problems. We analyzed the territorial programs of state guarantees of some subjects of the Russian Federation. Also, from the territorial CHI Funds (TFOMS) we received information on the performance of TPSG indicators: the
volume of care in round-the-clock and day hospitals, planned and actually performed molecular genetic studies and cases of positron emission tomography combined with computed tomography in 2021 and the first half of 2022 of the year. We found significant problems, some of which have causes at the federal level, others are purely regional in nature, which lead to significant differences in planning the volume of medical care between the subjects of the Russian Federation. Conclusion. Planning the volume of medical care in the field of “Oncology” varies significantly between the subjects of the Russian Federation and has systemic difficulties, control over the effective use of funds is insufficient. We consider it necessary when planning medical care for the oncology profile in the Program of State Guarantees of
Free Medical Care to take into account the standardized incidence rate per 100,000 population, and not the number of insured persons in the subject.