Regional Economics: Theory and Practice

Assessment of the quality of health in the Russian Federation regions

Vol. 15, Iss. 11, NOVEMBER 2017

Received: 5 September 2017

Received in revised form: 27 September 2017

Accepted: 18 October 2017

Available online: 15 November 2017


JEL Classification: I15

Pages: 2070–2093

Fedorova E.A. Financial University under Government of Russian Federation, Moscow, Russian Federation

Chernikova L.I. Financial University under Government of Russian Federation, Moscow, Russian Federation

Rogov O.Yu. Financial University under Government of Russian Federation, Moscow, Russian Federation

Subject The article deals with the study of the quality of health at the regional level, identifying the relationship between budget costs and the quantitative and qualitative indicators of the healthcare industry in the Russian Federation.
Objectives The article aims to assess the quality of health in the regions through a cluster approach.
Methods For the study, as the source data, we used data from the Federal State Statistics Service compendiums for each region of Russia. The analysis covers an array of data for 2006–2015. As well, we used the method of index numbers. To select clusters, we applied a variance test.
Results In the course of the study, three cluster groups were identified for consideration. The analysis found no unequivocal correlation between qualitative and quantitative health indicators and health costs.
Relevance The proposed clustering of the Russian Federation regions will make it possible to identify problems that impede quality improvement in healthcare.

Keywords: cluster analysis, index theory, healthcare quality


  1. Motrich E.L., Naiden S.N. [Standard of living of the population and social potential in the Far East regions of Russia]. Uroven' zhizni naseleniya regionov Rossii = Standard of Living of the Population of the Regions of Russia, 2013, no. 1, pp. 18–24. (In Russ.)
  2. Bhargava A., Jamison D.T., Lau L.J., Murray Ch.J.L. Modeling the Effects of Health on Economic Growth. Journal of Health Economics, 2001, no. 20, pp. 423–440. URL:
  3. Ogungbenle S., Olawumi O.R., Obasuyi F.O.T. Life Expectancy, Public Health Spending and Economic Growth in Nigeria: A Vector Autoregressive (VAR) Model. European Scientific Journal, 2013, vol. 9, no. 19, pp. 210–235. URL:
  4. Vandersteegen T., Marneffe W., Cleemput I., Vereeck L. The Impact of No-Fault Compensation on Health Care Expenditures: An Empirical Study of OECD Countries. Health Policy, 2015, vol. 119, iss 3, pp. 367–374. URL:
  5. Blanco-Moreno A., Urbanos-Garrido R.M., Thuissard-Vasallo I.J. Public Healthcare Expenditure in Spain: Measuring the Impact of Driving Factors. Health Policy, 2013, vol. 111, iss. 1, pp. 34–42. URL:
  6. Gilligan A.M., Skrepnek G.H. Determinants of Life Expectancy in the Eastern Mediterranean Region. Health Policy and Planning, 2015, vol. 30, iss. 5, pp. 624–637. URL:
  7. Chetty R., Stepner M., Abraham S., Cutler D. et al. The Association Between Income and Life Expectancy in the United States, 2001–2014. Journal of American Medical Association, 2016, no. 4, pp. 1750–1766. URL:
  8. Anderson G.F., Hussey P.S. Comparing Health System Performance in OECD Countries. Health Affairs, 2001, vol. 20, iss. 3, pp. 219–232. URL:
  9. Filmer D., Pritchett L. The Impact of Public Spending on Health: Does Money Matter? Social Science & Medicine, 1999, vol. 49, iss. 10, pp. 1309–1323. URL:
  10. Farag M., Nandakumar A., Wallack S. et al. Health Expenditures, Health Outcomes and the Role of Good Governance. International Journal of Health Care Finance and Economics, 2013, vol. 13, iss. 1, pp. 33–52. URL:
  11. Rajkumar A.S., Swaroop V. Public Spending and Outcomes: Does Governance Matter? Journal of Development Economics, 2008, vol. 86, iss. 1, pp. 96–111. URL:
  12. Marwân-al-Qays Bousmah, Bruno Ventelou, Mohammad Abu-Zaineh. Medicine and Democracy: The Importance of Institutional Quality in the Relationship between Health Expenditure and Health Outcomes in the MENA Region. Health Policy, 2016, vol. 120, iss. 8, pp. 928–935. URL:
  13. Hartman M., Catlin A., Lassman D. et al. U.S. Health Spending by Age, Selected Years through 2004. Health Affairs, 2008, vol. 27, iss. 1, pp. 1–12. URL:
  14. Barros P.P. The Black Box of Health Care Expenditure Growth Determinants. Health Economics, 1998, no. 7, pp. 533–544. URL:;2-B
  15. Roberts J. Sensitivity of Elasticity Estimates for OECD Health Care Spending: Analysis of a Dynamic Heterogeneous Data Field. Health Economics, 1999, vol. 8, iss. 5, pp. 459–472. URL:<459::AID-HEC454>3.0.CO;2-U
  16. Gerdtham U.G., Søgaard J., Andersson F., Jönsson B. An Econometric Analysis of Health Care Expenditure: A Cross-Section Study of the OECD Countries. Journal of Health Economics, 1992, vol. 11, iss. 1, pp. 63–84. URL:
  17. Murthy N.R.V., Ukpolo V. Aggregate Health Care Expenditure in the United States: Evidence from Cointegration Tests. Applied Economics, 1994, vol. 26, iss. 8, pp. 797–802.
  18. Dormont B., Grignon M., Huber H. Health Expenditure Growth: Reassessing the Threat of Ageing. Health Economics, 2006, vol. 15, iss. 9, pp. 947–963. URL:
  19. Lubitz J., Cai L., Kramarow E., Lentzner H. Health, Life Expectancy, and Health Care Spending Among the Elderly. The New England Journal of Medicine, 2003, vol. 349, iss. 11, pp. 1048–1055.
  20. Crivelli L., Filippini M., Mosca I. Federalism and Regional Health Care Expenditures: An Empirical Analysis for the Swiss Cantons. Health Economics, 2006, vol. 15, iss. 5, pp. 535–541. URL:
  21. Wang Z. The Determinants of Health Expenditures: Evidence from US State-Level Data. Applied Economics, 2009, vol. 41, iss. 4, pp. 429–435. URL:
  22. Baltagi B.H., Moscone F. Health Care Expenditure and Income in the OECD Reconsidered: Evidence from Panel Data. Economic Modelling, 2010, vol. 27, iss. 4, pp. 804–811. URL:
  23. Ang J.B. The Determinants of Health Care Expenditure in Australia. Applied Economics Letters, 2010, vol. 17, iss. 7, pp. 639–644. URL:
  24. Breyer F., Felder S. Life Expectancy and Health Care Expenditures: A New Calculation for Germany Using the Costs of Dying. Health Policy, 2006, vol. 75, iss. 2, pp. 178–186. URL:
  25. Fries J.F. Aging, Natural Death, and the Compression of Morbidity. The New England Journal of Medicine, 1980, vol. 303, iss, 3, pp. 130–135. URL:
  26. Zweifel P., Felder S., Meiers M. Ageing of Population and Health Care Expenditure: A Red Herring? Health Economics, 1999, vol. 8, iss. 6, pp. 485–496. URL:<485::AID-HEC461>3.0.CO;2-4
  27. Aisa R., Clemente J., Pueyo F. The Influence of (Public) Health Expenditure on Longevity. International Journal of Public Health, 2014, vol. 59, iss. 5, pp. 867–875. URL:
  28. Getzen T.E. Population Ageing and the Growth of Health Expenditure. Journal of Gerontology, 1992, vol. 47, iss. 3, pp. 98–104.
  29. Richardson J., Robertson I. Ageing and the Cost of Health Services. In: Policy Implications of the Ageing of Australia's Population, Conference Proceedings. Melbourne, Productivity Commission and Melbourne Institute of Applied Economic and Social Research, 1999.
  30. Kleine A., Dellnitz A., Rödder W. Sensitivity Analysis of BCC Efficiency in DEA with Application to European Health Services. In: Huisman D., Louwerse I., Wagelmans A. (eds) Operations Research Proceedings 2013. Operations Research Proceedings (GOR (Gesellschaft für Operations Research e.V.)). Springer, Cham, 2014, pp. 243–248. URL:
  31. Slavova T. A Rank Order and Efficiency Evaluation of the EU Regions in a Social Framework. Empirica, 2008, no. 35, pp. 339–367.
  32. Zhgun T.V. [Building an integral measure of the quality of life of constituent entities of the Russian Federation using the principal component analysis]. Ekonomicheskie i sotsial'nye peremeny: fakty, tendentsii, prognoz = Economic and Social Changes: Facts, Trends, Forecast, 2017, vol. 10, iss. 2, pp. 214–235. (In Russ.) URL:
  33. Glushanko V.S., Alferova M.V. [Efficiency of the Belorussian model of health care system and medicinal provision of population]. Vestnik farmatsii, 2016, no. 2, pp. 20–29. (In Russ.)

View all articles of issue


ISSN 2311-8733 (Online)
ISSN 2073-1477 (Print)

Journal current issue

Vol. 16, Iss. 3
March 2018