This report examines three criticallyimportant areas to inform discussions on the appropriatelevel of health care spending in the Russian Federation: (i)the efficiency of spending on health care services; (ii)distributional impacts of spending on health care services;and (iii) the key factors that will influence the growth inhealth care spending over the next 20 years. There are fewdata showing how spending in health care in the RussianFederation translates into better health outcomes such asimproved mortality, improved morbidity, increased economicoutput and productivity, improvements in the number of lifeyears gained, or more sophisticated composite measures suchas Quality Adjusted Life Years (QALYs). There is alsolimited data on outputs of hospitals and other healthcareproviders which allow controlling for case mix,socioeconomic status, supply-side variables, and quality ofcare. Therefore, it is difficult to assess the efficiency ordistributional impacts of health interventions. While theanalysis draws on primary data specifically collected forthe study, the absence of detailed output and outcome datanecessarily limits the scope of the study and its findings.
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