+7 495 989 9610, 9am6pm (GMT+3), Monday – Friday
ИД «Финансы и кредит»






National Interests: Priorities and Security

Comparing the efficiency of national healthcare systems

Vol. 15, Iss. 8, AUGUST 2019

Received: 5 June 2019

Received in revised form: 21 June 2019

Accepted: 14 July 2019

Available online: 15 August 2019


JEL Classification: I15, I18, J13

Pages: 1495–1511


Molchanova E.V. Institute of Economics of Karelian Scientific Center of Russian Academy of Sciences (IE KarRC RAS), Petrozavodsk, Republic of Karelia, Russian Federation

ORCID id: not available

Subject The article reviews national healthcare systems with different models of medical aid and their design worldwide.
Objectives The research evaluates and compares the efficiency of national healthcare systems through the Global Burden of Disease Study. I also determine the most promising areas and aspects for public health preservation and improvement.
Methods The research is methodologically based on the philosophy of the Global Burden of Disease Study. The program refers to DALY (Disability Adjusted Life Years). The metric DALY = YLL + YLD for various diseases or health problems accounts for years lost due to ill health or early death (YLL) and years lost due to disability (excluding fatal cases, YLD).
Results I evaluated the efficiency of national healthcare systems in the countries having different medical aid schemes, including the Beveridge model (United Kingdom), Bismark model (Germany, Russia, Japan) and private healthcare system (USA). The article analyzes DALY in the analyzable group of countries and determines key causes of morbidity and mortality. I spotlight the development of Russia's healthcare system, emphasizing strengths and weaknesses of medical aid in the country.
Conclusions and Relevance The methodology of the Global Burden of Disease Study proved to be efficiency and can be used to compare and evaluate the public health. The findings can serve for preparing program documents to overcome demographic crisis and create new approaches to public health protection.

Keywords: demography, healthcare system, medical care


  1. Molchanova E.V. Mediko-demograficheskie protsessy kak otrazhenie sotsial'no-ekonomicheskikh uslovii zhizni obshchestva v Rossii, Respublike Kareliya i Finlyandii [Medical and demographic processes as a reflection on the socio-economic conditions of social life in Russia, the Republic of Karelia and Finland]. Petrozavodsk, KarRC RAS Publ., 2012, 163 p.
  2. GBB 2016 Causes of Death Collaborators. Global, Regional, and National Age-Sex Specific Mortality for 264 Causes of Death, 1980–2016: A Systematic Analysis for the Global Burden of Disease Study 2016. Lancet, 2017, vol. 390, iss. 10100, pp. 1151–1210. URL: Link32152-9
  3. Murray C.J.L., Lopez A.D. The Global Burden o f Disease: A Comprehensive Assessment of Mortality and Disability from Diseases, Injuries, and Risk Factors in 1990 and Projected to 2020. Harvard University Press on behalf of the World Health Organization and The World Bank, 1996.
  4. Liaropoulos L., Goranitis I. Health Care Financing and the Sustainability of Health Systems. International Journal for Equity Health, 2015, vol. 14, iss. 1, p. 80. URL: Link
  5. Dudnuk V.Yu. [Models of health care system development: Global experience (literature review)]. Mezhdunarodnyi zhurnal prikladnykh i fundamental'nykh issledovanii = International Journal of Applied and Fundamental Research, 2016, no. 3-1, pp. 60–64. URL: Link (In Russ.)
  6. Molchanova E.V., Burkin M.M. [The possibility of introducing benchmarking in public health systems]. Ekonomika i predprinimatel'stvo = Journal of Economy and Entrepreneurship, 2018, no. 3, pp. 1267–1275. (In Russ.)
  7. Alpatova G.M. [On the onset of the social State: W. Beveridge]. Vestnik Permskogo universiteta. Istoriya = Perm University Herald. History, 2009, no. 1, pp. 92–97. URL: Link (In Russ.)
  8. Shcherbakova A.A. [Institutional aspects of innovative development of health care]. Problemy razvitiya territorii = Problems of Territory's Development, 2015, no. 4, pp. 46–56. (In Russ.)
  9. Wenzl M., McCuskee S., Mossialos E. Commissioning for Equity in the NHS: Rhetoric and Practice. British Medical Bulletin, 2015, vol. 115, iss. 1, pp. 5–17. URL: Link
  10. Bespalova L.N. [Otto von Bismark's social policy as covered by Vestnik Evropy (Bulletin of Europe)]. Vestnik TGPU = Tomsk State Pedagogical University Bulletin, 2013, no. 7, pp. 69–75. URL: Link (In Russ.)
  11. Thomson S., Foubister T., Mossialos E. Financing Health Care in the European Union. Challenges and Policy Responses. Copenhagen, European Observatory on Health Systems and Policies, 2009, 224 p.
  12. Luk'yantseva D.V., Tatarinov A.P., Mel'nikova L.S. [International practices in funding of health care systems]. Mezhdunarodnye tekhnologii. Otsenka i vybor = International Technologies. Assessment and Choice, 2017, no. 2, pp. 20–29. (In Russ.)
  13. Busse R., Blumel M. Germany. Health System Review. Health Systems in Transition, 2014, vol. 16, no. 2, pp. 1–296.
  14. Tatara K., Okamoto E. Japan. Health System Review. Health Systems in Transition, 2009, vol. 11, no. 5, pp. 1–162.
  15. Dzyadz'ko A.M., Novik I.I., Masyuk M.Yu., Karanik V.S. [Health care system of the US: Point of view of Belarusian specialists]. Meditsinskie novosti = Medical News, 2014, no. 7, pp. 37–50. (In Russ.)
  16. Obama B. United States Health Care Reform: Progress to Date and Next Steps. Journal of the American Medical Association, 2016, vol. 316, no. 5, pp. 525–532. URL: Link
  17. Zeveleva G.N. [Healthcare reform in the United States: Difficult road]. Mirovaya ekonomika i mezhdunarodnye otnosheniya = World Economy and International Relations, 2015, no. 4, pp. 81–89. (In Russ.)
  18. Gorelova L.E., Surovtseva T.I. [Zemstvo district medicine and charity in Russia]. Istoriya meditsiny = History of Medicine, 2014, no. 4, pp. 29–34. (In Russ.)
  19. Kachaeva T.M., Dei A.A. [Historical aspects of the formation of health insurance]. Tikhookeanskii meditsinskii zhurnal = Pacific Medical Journal, 2015, no. 1, pp. 96–100. URL: Link (In Russ.)
  20. Gasnikov V.K. [Health care reforms in Russia: Stages and effectiveness]. Zdorov'e, demografiya, ekologiya finno-ugorskikh narodov = Health, Demography, Ecology of Finno-Ugric People, 2016, no. 1, pp. 40–43. (In Russ.)
  21. Goryunova V.V. [Comparative characteristics of the German and Russian system of compulsory medical insurance]. Aktual'nye problemy i perspektivy razvitiya ekonomiki: rossiiskii i zarubezhnyi opyt = Current Problems and Prospects of Economic Development: Russian and Foreign Experience, 2015, no. 1, pp. 117–121. (In Russ.)

View all articles of issue


ISSN 2311-875X (Online)
ISSN 2073-2872 (Print)

Journal current issue

Vol. 17, Iss. 11
November 2021