Regulation of inter-regional differences of the Russian Federation regions in the context of national projects «Healthcare» and «Demography»

Abstract

The subject of the study is the inter-regional differences in the state of public health and the demographic situation in the Russian Federation regions. The theoretical aspect of the subject is determined by the development of priorities of the Russian healthcare development strategy aimed at alignment of regional differences in the levels of healthcare development in the Russian Federation regions. The empirical aspect of the subject is to identify interregional differences in the state of public health and the demographic situation in the Russian Federation regions by using the EM cluster analysis method (Expectation Maximization). The method was implemented in the integrated development environment RStudio. The official statistics from Rosstat for the period 2014–2018 were used as the initial dataset. The purpose of the study is justifying the regulation of inter-regional differences of the Russian Federation regions. As a result of clustering, nine homogeneous clusters of the Russian Federation regions were identified. The main characteristics of the formed clusters are determined. Among the priorities of the RF healthcare development strategy are as follows: implementation of a unified tariff policy in the system of compulsory medical insurance; ensuring the balance of territorial compulsory medical insurance programs within the framework of the basic programme of compulsory medical insurance through financial security based on a single per capita standard; development of telemedicine, providing prompt remote consultation of leading experts in the provision of medical care, regardless of the territorial location of the patient and the doctor; ensuring the implementation of distance education courses and continuing education programs for medical workers; rationalization of the distribution of resources and capacities of medical organizations based on a three-tier system of medical care; development of regional public health centres. The results of this study can be used to develop federal and territorial programs for socioeconomic development, formulate a strategy for the development of healthcare at macro- and meso- levels, and optimize decisions of regional authorities regarding population policy.