Public–Private Partnership in Health Care of Russia

Abstract

The paper is devoted to new social and economical phenomena in health care system of Russia. The interaction between the public and the private sectors for solving socially significant tasks has a long history. However, the Public-Private Partnership in its modern form has acquired the greatest relevance only in recent decades. Both the state partner and the private investor benefit from such a cooperation: high technologies allow to help a larger number of the population, which leads to reducing the number of disabled people, sick leaves, increasing life expectancy and efficiency of the population. In connection with this benefit, the expediency of using this type of partnership in the field of health is clear. As we all know, the best treatment is prevention, which can be provided in these medical centers with a more thorough diagnosis of diseases, which will improve health of citizens and ensure a higher quality of their lives.

The aim is to describe and analyse the current state of affairs in the field of public-private partnership in the field of health in Russia.

Methodology In my research, a social mapping method might be used that compares the productivity of health centres operating on the basis of PPPs across regions in the form of a comparison with the statistical data of the basic life indicators of the population. This method allows to convert social data into a visual map form, i.e. create maps of social phenomena and processes occurring in any socio-territorial community.

Theoretical Framework The topic of interest was considered by T. Parsons. Public-private partnership is an active system with institutions and a structure that is gradually penetrating into almost all spheres of life of the population and functions not only as a market structure with a special status, but also influences health indicators, raising living standards and technology development, and exemplifies existing opportunities for interaction between the state and business in the country.

Hypothesis The main hypothesis is that in regions where there are health centers based on PPP, mortality statistics should be lower than in other regions where such centers are not founded or are under development. To test this hypothesis, I have made a comparison of the circulatory system in the table of statistical indicators that were selected for use in hemodialysis centers, implemented on the basis of PPP in 6 regions from 2012 to 2016.

Parameters for Analysis Hemodialysis is a treatment of acute and chronic renal failure with the aid of the apparatus "artificial kidney". I have analyzed the mortality rate from diseases of the blood in six regions before the PPP centers appeared and provoked changes that have occurred since the moment of exploitation to the present. After that I have compared the average decrease in mortality in each region with an average decrease in mortality in the rest of the Russian Federation.

Results In each of the six analyzed regions, a decrease in mortality is observed. One of the leaders among them is the Republic of Tatarstan, which had one of the lowest indicators (almost 25 thousand deaths) before the creation of the PPP project. In 2016, this number fell to 17.4 thousands - 7,498 deaths less.

The positive dynamics of the decline in mortality in comparison with 2013 is observed both in regions where medical centers are based on PPP and in other regions of the country. At the same time, it should be noted that the average for the regions where the new centers were created was initially better than the average for the rest of the regions (13.8 thousand against 33.2 thousand deaths in 2013).

Thus, comparing the effectiveness of the mortality rate with other regions of the country, we can admit that in these regions mortality decreased to 9.1 thousand per year, while in the remaining regions it decreased to 21.7 thousand. However, the list of other regions includes Moscow and St. Petersburg, where indicators are almost always higher than in others.

Future Research For future research, we see it reasonable to compare subject estimates - for example, the websites of these health care centers, namely, content analysis of comments or consider coverage of this topic in various forums about health, business or social improvement; to reveal the level of awareness of the population about the topic, or to gather expert opinion on how these centers are operated, what the population's reaction to their creation and functioning is, what working conditions are received by medical workers here, what are the partners' conclusions about projects, etc.