Utilization of public and private healthcare facilities: patient choice

Abstract

Healthcare system in Russia lets patients choose where they want to get medical services: at public or private healthcare facilities. This choice may depend on several factors. According to Andersen’s healthcare utilization model, these factors can be divided into three groups: predisposing, enabling and need factors. The purpose of this study is to identify factors determining patient choice between public and private healthcare providers in Russia. Statistical and regression analysis was carried out using 2019 Rosstat data. We found that men and people from older age groups were more likely to attend public facilities, while people with higher education, employed and living in larger cities were more likely to attend private clinics. Higher income, having supplemental health insurance, and receiving medical services outside one’s city were associated with an increase in probability of using private healthcare providers. Analysis of need factors showed that worse health in individuals was associated with increased probability of choosing private medical organizations, whereas disability was associated with decreased probability of making the same choice.