Medico-Economic Standards in Russia: Balancing Legal Requirements and Patients Needs
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Medico-economic standards (MES) are a relatively recent innovation in the Russian public health-care system. MES specify the kinds and quantities of diagnostic and treatment services a patient with a particular health condition should receive. They are meant to simultaneously control costs and quality of care, and medical professionals in public institutions have a legal obligation to follow these standards. This chapter explores how MES work in practice and how health-care practitioners attempt to reconcile demands of MES, realities of their practice, and demands of patients. The chapter stresses that in mediating these, health-care practitioners place themselves in a precarious position of balancing between being legally sanctioned and providing inadequate medical help.
I would like to express my deep gratitude for the paediatricians who agreed to participate in my study and share their stories and experiences of working with medico-economic standards. I would also like to thank the editors of this book, Klasien Horstman, Olga Zvonareva, and Evgeniya Popova for their relevant comments, helpful advices, and moral support. Another person whom I would like to thank is Olga Federova for her expertise and very helpful comments on my work. In addition, I would like to acknowledge Lloyd Akrong for his help in proofreading the English of parts of this chapter.
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