Vertical program of screenings and check‑ups in the Russian Federation: design, implementation and lessons learnt

Archives of Public Health. 2022. Vol. 80. No. 123. Article 123.

Sheiman I., Shishkin S., Sazhina S. V.

Background: The Russian Federation has introduced a vertical large-scale program of ‘dispensarization’ (Program)
that includes health check-ups and screenings for the entire adult population. It is expected to improve the results of
medical interventions and ensure health gains at a relatively low cost. The major research question: Does the design
and implementation of the program meet the expectations?
Methods: We analyze regulatory acts and the literature on the design and the outcomes of the Program. Physicians’
surveys and interviews are conducted to understand the capacity of primary care providers to meet the requirements
of the Program, as well as the link between the early identification of new illnesses and their follow-up management,
administration of the program, the barriers to its successful implementation.
Results: There is a substantial progress in the coverage of the population and increase in the number of identified
illnesses. Some specific instruments of the Program implementation work well, others require more careful design
and additional integrative and managerial activities. The capacity of primary care providers does not allow to provide
high quality preventive services, as well as to ensure a continuum of preventive and curative work. The pattern of the
Program administration facilitates its nation-wide implementation according to the unified rules, but makes it more
difficult to account for the local conditions and limits the autonomy of professionals to choose specific population risk
groups and a list of services. The interaction of providers in preventive activities is inadequate.
Conclusion: The expectations of the Program are too high due to the inconsistencies in its design and implementation.
The major lesson learnt is that the program like this should meet the capacity of primary care and be designed as
a complex of interrelated activities to identify illnesses and provide their follow-up management.

Keywords: public health, Russian Federation, Vertical health program, Screenings

Publication based on the results of: Evolution of compulsory health insurance institutions (2021)