THE RESEARCH LANDSCAPE OF HEALTH EFFECTIVENESS RESEARCH IN RUSSIA: AN ANALYTICAL REVIEW

Abstract

Significance The relevance of the study lies in the systematic analysis of scientific and methodological approaches to the study and evaluation of health care as a multidimensional and multi-level system. Aim: to systematise the results of original research aimed at examining the effectiveness of health care. Methods A retrospective categorical and substantive analysis of original studies belonging to the genre "scientific article" and devoted to the effectiveness (quality) of the health care system in Russia, published in domestic scientific periodicals during the period from 2011 to 2021, was carried out. The categorical analysis included the following parameters: "healthcare system", "efficiency", "methods". Based on the inclusion and exclusion criteria, 48 sources were selected. All original studies were divided into two groups according to the author's specialty: medical and non-medical. The content analysis allowed revealing and parameterization of scientific-methodological tendencies of researches of public health effectiveness by statistical-structural-dynamic characteristics of researches and specialities of the author (medical and non-medical specialities). The main methods used in the original research were analysed. Statistical significance of differences was revealed by Fisher's exact test at significance level p0.05. Results A categorical analysis for the period 2011-2021 revealed 144 publications. The usual selection process excluded 17 publications. For further analysis 48 scientific articles were used. The structure of scientific publications was dominated by the results of original research - 64%. No systematic reviews and meta-analyses were identified. The increase in the dynamics of publication activity on the stated topic was due to original research. Most of the trials were conducted at the meso-level - 70.8%. There are virtually no works devoted to the results of original research conducted at the countrywide level. A set of sociological, medical-statistical and econometric methods is used as the main research tool for studying efficiency. Sociological methods and methods of analysis of official medical statistics prevail in "pure" form. The methods of demography and mathematical modelling were used least of all. No quantitative differences were found in the authors' specialisation. Differences are observed in the authors' gravitation towards the study of different types of efficiency depending on the researchers' specialty, as well as the frequency of studies of economic and social efficiency in their study at the meso- and macro-level, and the use of methodological apparatus in the study of these types of efficiency. Conclusions The core of the publication activity is formed by the results of original research obtained at the meso-level; research conducted at the macro-level is practically absent. Systematic reviews and meta-analyses are completely absent. There is a homogeneity in the use of different types of effectiveness research methods.