Oleg Abdurashitov's picture

What Russian Patients Think of Healthcare

These days, healthcare discussions start with [[wysiwyg_imageupload:123:]]
figures – so here are some basic Russian statistics.

According to UN estimates the average life expectancy in Russia is only 69 years (in the US, ranked only 49th out of 200 countries, life expectancy is over 78 years). To take one example, the mortality rate of vascular diseases is 900 cases on every 100,000 people – almost three-folds that of the US, but more importantly one-third higher than in neighboring Bulgaria and twice as much as Hungary. Similar patterns are observed in oncology, trauma and even infectious diseases. 

Russians themselves hugely contribute to those striking figures by their very lifestyle. They are among the heaviest drinkers (alcohol consumption is about 15 liters annually, WHO Report on Alcohol and Health) and smokers (41% of adults). Only 44% visit a doctor at least once a year. Why care? 65% or Russians still consider themselves healthy!  

But the Russian healthcare system itself is at a critical turning point. For over a decade it was chronically underfunded – while the US healthcare spending almost tripled since ’93, in Russia the budgets of ’93 in real value were matched only once in 2007 (and that is after a decade-long 30% slump). The dramatic increase of healthcare expenditure in the last five years and series of major government initiatives on one hand added two more years to the average life expectancy, but on the other were often accompanied by corruption scandals.  Access to high-quality modern medicine is still low to date.

In addition to that, Russian healthcare is plagued by inefficiency – WHO research states that mere 7-20% of available resources are used optimally, and over 80% are not. That’s why despite having the fourth biggest ratio of physicians per population and the third biggest rate of hospital beds worldwide, we treat patients at hospital twice as long as France, but the cardiac mortality rate is still 6 times higher. 

Overall, it’s no surprise that 40% of Russians (think of over 60 million people) consider healthcare poor and 25% think it became worse in the last years (FOM Study, 2011). The surprise is that there are only two critical factors of patient dissatisfaction.  In a poll, conducted by insurance companies, Russians repeatedly named rudeness of clinical personnel and queue waiting time as the top quality indicators of medical services.

Of course, one should not expect the overstressed, overloaded and chronically underpaid Russian physicians and nurses to act like five-star hotel hosts. And Russian clinical management struggling to simply maintain the facilities, where ceilings can literally fall on the patient’s head, have almost no time to manage the patients’ flow.

But these very basics of human relations and good management cost next to nothing – that’s the reason why cash infusions alone won’t work. Unfortunately, adding nothing to the bottom line, these factors often remain under the radar of healthcare reforms driven by the new law on Health Protection and leave patients with their mistrust.

In addition to fundamental task of modernizing the clinics, educating doctors, securing funding and promoting healthy lifestyle, the healthcare reforms are now facing the communications challenge of restoring the patients’ confidence – through listening and addressing their concerns.