Расширение потребительского выбора в здравоохранении: насколько оправданны ожидания?
Till 2008 remuneration system based on the unified tariff scale was officially implemented for the public sector of the Russian economy. New remuneration system (NRS) is intended to differentiate wages more clearly, bring it into compliance with output of labour input, eliminate the disproportion in the structure of employment, which are common for public sector. In this work was made an effort to estimate results of the remuneration reform with the example of medical institutions of three regions, which sequentially introduced NRS in 2008-2009. The estimates based on the Monitoring of healthcare economic problems microdata reveal the increase of wages and salaries within institutions that adopted NRS.
We address the external effects on public sector efficiency measures acquired using Data Envelopment Analysis. We use the health care system in Russian regions in 2011 to evaluate modern approaches to accounting for external effects. We propose a promising method of correcting DEA efficiency measures. Despite the multiple advantages DEA offers, the usage of this approach carries with it a number of methodological difficulties. Accounting for multiple factors of efficiency calls for more complex methods, among which the most promising are DMU clustering and calculating local production possibility frontiers. Using regression models for estimate correction requires further study due to possible systematic errors during estimation. A mixture of data correction and DMU clustering together with multi-stage DEA seems most promising at the moment. Analyzing several stages of transforming society’s resources into social welfare will allow for picking out the weak points in a state agency’s work.