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Health Care Reform in the Former S oviet U nion: Beyond the Transition
Author(s) -
Balabanova Dina,
Roberts Bayard,
Richardson Erica,
Haerpfer Christian,
McKee Martin
Publication year - 2012
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/j.1475-6773.2011.01323.x
Subject(s) - payment , socioeconomic status , health care , stratified sampling , medicine , environmental health , consumption (sociology) , socioeconomics , business , economic growth , population , economics , finance , pathology , social science , sociology
Objective To assess accessibility and affordability of health care in eight countries of the former S oviet U nion. Data Sources/Study Setting Primary data collection conducted in 2010 in A rmenia, A zerbaijan, B elarus, G eorgia, K azakhstan, M oldova, R ussia, and U kraine. Study Design Cross‐sectional household survey using multistage stratified random sampling. Data Collection/Extraction Methods Data were collected using standardized questionnaires with subjects aged 18+ on demographic, socioeconomic, and health care access characteristics. Descriptive and multivariate regression analyses were used. Principal Findings Almost half of respondents who had a health problem in the previous month which they viewed as needing care had not sought care. Respondents significantly less likely to seek care included those living in A rmenia, G eorgia, or U kraine, in rural areas, aged 35–49, with a poor household economic situation, and high alcohol consumption. Cost was most often cited as the reason for not seeking health care. Most respondents who did obtain care made out‐of‐pocket payments, with median amounts varying from $13 in Belarus to $100 in A zerbaijan. Conclusions Access to health care and within‐country inequalities appear to have improved over the past decade. However, considerable problems remain, including out‐of‐pocket payments and unaffordability despite efforts to improve financial protection.