Understanding Russia's Regional Health Markets

Russia is a nation of huge economic contrasts. The country has generated a great deal of mineral wealth yet spends a comparatively small amount of GDP on health, at 5.6% in 2010. The Russian health system, in the main, remains outmoded and undercapitalized. But things are changing.

Any assessment of Russia must consider the recent improvements, ambitious plans and the challenges that are influencing the development of the health market and answer key questions such as:

- How is the population and wealth regionally distributed?
- Which provinces produce the highest levels of GDP?
- To what degree does Moscow skew analysis of Russia’s financial and health infrastructure?
- What is the primary and secondary health infrastructure in each region?
- How is healthcare delivered?
- What is the changing role played by private health provision?
- Which regions are better provided for and which still need investment?

Identifying opportunities in Russia’s expanding health economy requires detailed knowledge of the economic performance and health infrastructure at a regional level. Being able to see that in the context of the neighbouring districts/regions as well as the national picture, brings focus to areas of opportunity and need.

Rich in statistics, charts and maps, this new 354-page report from Espicom Understanding Russia's Regional Health Markets takes you further into understanding the national and regional health environments.

Snapshots on the Russian health market

- The Russian Federation is the largest country in the world, with a land area of over 17 million square kilometres, encompassing eleven time zones. After the breakup of the USSR in 1991, the Russian Federation retained over 75% of the USSR's total land area and 51% of its population.
- The population of Russia was estimated at 142.9 million in 2010, an increase of 0.71% over 2009. Prior to 2010 growth rate remained negative, decreasing by an average of 0.4% each year since 1999.
- Non-communicable diseases that are related to unhealthy lifestyles remain a major problem in Russia. Over 9 million deaths could be avoided each year. Often the risk factors lie with smoking, alcohol abuse, the use of saturated fat and excessive salt intake.
- Smoking is a major cause of ill health. There were 54.2 million cases of respiratory disease (24.0% of the total) and 32.4 million cases of circulatory disease (14.3%). Unsurprisingly, the leading site for new cancer cases in males was the trachea, bronchus & lung, with 46,400 cases, or 19.5% of the total.
- Russia spent 5.6% of GDP on healthcare in 2010, equal to US$82.4 billion, or US$581 per capita. Just over 62% of this was in the public sector, worth US$51.1 billion or US$361 per capita. The government intends to gradually increase public healthcare spending to 6-7% of GDP as part of its ambitious plans to improve the health of the Russian people.

A TALE OF TWO REGIONS – UNDERSTANDING THE CHALLENGE OF WEALTH AND HEALTH DISTRIBUTION

Moscow City and Ivanovo are both located in the Central Federal District, yet they show markedly different economic and health profiles.

Indicator
GRP Per Capita
Health/Social Expenditure per capita Medical Insurance Per Capita
Death rate per ‘000
Average beds per hospital
Doctors rate per ‘000

Moscow City
US$21,457
US$665
US$265
10.9
465
8.5

Ivanovo
US$2,540
US$193
US$90.5
18.4
190
5.0

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Summary

Geography

Political and Economic Background
Politics
Economy

Demography
Population
Demographic indicators
Birth Rate
Death Rate
Infant Deaths
Life Expectancy at Birth
Morbidity
Communicable Diseases
Non-communicable Diseases
Mortality

Healthcare Sector
Organisation
Concept for the Development of the Healthcare Sector until
National Health Project
Project Funding
Salary Increases for Healthcare Personnel
Procurement of New Equipment
Construction of Medical Centres
Increasing the Availability of Advanced Medical Treatment
Prenatal and Postnatal Care
Reducing the Mortality Rate Linked to Cardiovascular Diseases and Road Accidents
Reducing the Mortality Rate Linked to Cancer
Regional Healthcare Modernisation Programme
Health Expenditure
Organisation of Expenditure
Public Sector
Private Sector
Locally-Sourced Expenditure Data
Primary Care
Hospital Facilities
Hospital Activity
Medical Personnel

Provincial Data Comparisons
National Comparison by Federal District
Central Federal District
Geography
Demographics
Economic background
Healthcare expenditure
Healthcare facilities
Healthcare personnel
Belgorod
Bryansk
Vladimir
Voronezh
Ivanovo
Kaluga
Kostroma
Kursk
Lipetsk
Moscow Region
Orel
Ryazan
Smolensk
Tambov
Tver
Tula
Yaroslavl
Moscow City
North West Federal District
Geography
Demographics
Economic background
Healthcare expenditure
Healthcare facilities
Healthcare personnel
Republic of Karelia
Republic of Komi
Archangelsk
Vologda
Kaliningrad
Leningrad (region)
Murmansk
Novgorod
Pskov
St Petersburg
Southern Federal District
Geography
Demographics
Economic background
Healthcare expenditure
Healthcare facilities
Healthcare personnel
Republic of Adygea
Republic of Kalmykia
Krasnodar
Astrakhan
Volgograd
Rostov
North Caucasus Federal District
Geography
Demographics
Economic background
Healthcare expenditure
Healthcare facilities
Healthcare personnel
Republic of Dagestan
Republic of Ingushetia
Kabardino-Balkaria
Karachay-Cherkess Republic
Republic of North Ossetia-Alania
Chechen Republic
Stavropol
Volga Federal District
Geography
Demographics
Economic background
Healthcare expenditure
Healthcare facilities
Healthcare personnel
Republic of Bashkortostan
Republic of Mari El
Republic of Mordovia
Republic of Tatarstan
Udmurt Republic
Chuvash Republic
Perm
Kirov
Nizhny Novgorod
Orenburg
Penza
Samara
Saratov
Ulyanovsk
Ural Federal District
Geography
Demographics
Economic background
Healthcare expenditure
Healthcare facilities
Healthcare personnel
Kurgan
Sverdlovsk
Tyumen
Chelyabinsk
Siberian Federal District
Geography
Demographics
Economic background
Healthcare expenditure
Healthcare facilities
Healthcare personnel
Altai Republic
Republic of Buryatia
Republic of Tyva
Republic of Khakassia
Altai Territory
Trans-Baikal Territory
Krasnoyarsk
Irkutsk
Kemerovo
Novosibirsk
Omsk
Tomsk
Far Eastern Federal District
Geography
Demographics
Economic background
Healthcare expenditure
Healthcare facilities
Healthcare personnel
Republic of Sakha
Kamchatka
Primorski Krai
Khabarovsk
Amur
Magadan
Sakhalin
Jewish Autonomous Region
Chukotka Autonomous Okrug

Provincial Ranking Tables
Total Population by Region (millions)
Population % Urban
Gross Regional Product (US$ billions)
Gross Regional Product Per Capita (US$)
Health & Social Services Expenditure, 2009 (US$ billions)
Health & Social Services Expenditure per capita, 2009 (US$)
Obligatory Medical Insurance Expenditure, 2010 (US$ millions)
Obligatory Medical Insurance Expenditure Per Capita, 2010 (US$)
Birth Rate per 000 Population,
Death Rate per 000 Population,
Infant Mortality Rate per 000 Live Births,
Total Number of Hospitals,
Number of Private Hospitals,
Number of Hospital Beds,
Hospital Beds per 000 Population,
Average Number of Beds per Hospital,
Number of Clinics,
Number of Physicians (000s),
Physicians (rate per 000 Population),
Number of Dentists (000s),
Dentists (rate per 000 Population),
Number of Nurses (000s),
Nurses (rate per 000 Population),
Number of Radiologists (000s),
Radiologists (rate per 000 Population),

Sources

LIST OF TABLES

Russian GDP and Real Growth, 2002-2
Population Estimates, 1990-2
Population by Gender & 5 Year Age Group, 2007-2
Urban & Rural Population by Gender, 2007-2
Principal demographic Indicators, 1995-2
Incidence of Selected Infectious & Parasitic Diseases, 1995-2010 (000s)
Incidence of Infectious Diseases in Urban & Rural Areas, 2000-2010 (000s)
Incidence of Selected Infectious Diseases by Region, 2010 (Per 100,000 Population)
Incidence of Socially Significant Diseases by Region, 2
Incidence of Active Tuberculosis by Age and Sex, 2000-2
Incidence of Active Tuberculosis in Urban & Rural Areas, 1995-2
Incidence of STIs, Fungal & Skin Diseases and Scabies, 1995-2
Incidence of STIs in Urban & Rural Areas, 1995-2
Incidence of Morbidity by Diagnosis, 2005-2010 (000s)
Incidence of Injury, Poisoning and Other External Causes, 2000-2
Incidence of Morbidity by Diagnosis & Region, 2010 (Per 1,000 Population)
Incidence of Malignant Neoplasms by Age and Sex, 2000-2
Incidence of Malignant Neoplasms by Sex and Site, 1995-2010 (000s)
Incidence of Cancer in Urban & Rural Areas, 1995-2
Incidence of Malignant Neoplasms by Region, 2
Deaths by Cause, 2006-2
Deaths by Cause, 2
Leading Causes of Death by Region, 2010 (Per 100,000 Population)
Infant Mortality by Cause, 2004-2
Infant Mortality by Cause, 2
Receipt and Expenditure of the Social Insurance Fund, 2009-2010 (Million Rubles)
Receipt and Expenditure of the Federal Compulsory Medical Insurance Fund, 2009-2010 (Million Rubles)
Receipt and Expenditure of Territorial Funds on Compulsory Medical Insurance, 2009-2010 (Million Rubles)
Voluntary Health Insurance Payments, 2000-2010 (Rubles 000s)
Outpatient Facilities by Type & Sector, 2000-2
Outpatient Facilities by Type & Sector in Urban & Rural Areas, 1995-2
MoH Outpatient Care Facilities, 1990-2
Condition of MoH Outpatient Clinics, 1995-2010 (%)
MoH Hospital Day Surgery Discharges by Group of Diseases, 2006-2
MoH Outpatient Unit/Polyclinic Day Surgery Discharges by Group of Diseases, 2005-2
Total Hospitals & Beds, 1990-2
Condition of MoH Hospitals, 1995-2
Hospitals & Beds by Sector, 1995-2
Hospitals & Beds by Sector in Urban & Rural Areas, 1995-2
Public Hospital Beds by Specialty, 1990-2010 (000s)
Public Hospital Beds by Specialty, 2010 (000s)
Hospital Beds by Specialty & Region, 2010
Hospital Beds by Specialty & Region, 2010 (Per 10,000 Population)
Public Hospital Activity, 1998-2010
MoH Hospital Activity by Type of Hospital, 2007-2010
Discharges in MoH Hospitals by Group of Diseases, 2006-2010
Discharges in MoH Hospitals by Group of Diseases, 2010
Average Stay in MoH Hospitals by Age & Group of Diseases, 2007-2010 (Days)
Surgical Procedures in MoH Hospitals, 2005-2010
Surgical Procedures in Public Hospitals, 2010
Public Sector Medical Personnel, 1990-2010 (000s)
Public Sector Doctors by Leading Specialty, 2003-2010 (000s)
Physicians by Specialty & Region, 2010