The article is devoted to the problem of increasing the participation of residents of Russia and its regions in the sphere of payment for medical services. The aim of the study is to analyze the current state and dynamics for the period from 2013 to 2023 of household expenditures on medical services in the context of healthcare commercialization and in a comparative inter-territorial profile (Vologda Region, Northwestern Federal District, and Russian Federation). We analyze the current situation and the main trends of recent years based on the data of official statistics (Rosstat) and the sociological survey results of the Vologda Region residents, conducted by VolRC RAS. As a result, we identify and describe the trends of growth in the share of health care expenditures in the total structure of consumer expenditures of residents of the Russian Federation and the Vologda Region. In relation to medical services proper, we can record even more noticeable changes. The obtained results indicate that the Vologda Region has a more pronounced practice of households’ participation in co-financing of medical services than in the country as a whole. We formulate the conclusion about the contradictory trends based on the data of the region’s sociological surveys. On the one hand, residents see and use a number of important advantages of the commercial sector. On the other hand, the increase in the share of expenditures on medical services may indicate the limited availability and quality of medical care provided on the basis of public institutions. The scientific novelty of the research results consists in approbation of the toolkit for subjective assessment of accessibility and quality of medical services provided by public and private health care organizations. The practical significance of the work lies in the possibility of clarifying the guidelines for the development of health care, taking into account current trends, namely in the search for a balance between the commercial and public sectors of the industry
Keywords
households, health care expenditures, expenditures on medical services, commercialization of health care, Russian Federation, subjects of the Northwestern Federal District, Vologda Region