Russian hospitals offer better treatment than clinics: patients named their top three complaints about medical care in compulsory health insurance

A sociological study showed that our hospitals now apparently offer better treatments than clinics.

Photo: Alexander GLUZ

About 40% of Russian patients are generally satisfied with the quality and availability of medical care within the framework of compulsory health insurance. And approximately one in five (21.9%) is dissatisfied. These data were presented by Tatyana Fomina, deputy director of the Social Mechanics research center, at a round table within the framework of the XIV All-Russian Congress of Patients, which is being held these days in Moscow.

With the support of the All-Russian Union of Patients (VSP), the center’s specialists conducted a sociological study “Evaluation of the availability and quality of medical services under the compulsory medical insurance policy in the Russian Federation in 2023.” More than 1,700 respondents from 81 regions of Russia participated. The survey showed: Apparently, our hospitals now provide better treatment than clinics.

Almost a quarter of patients, 24.4%, expressed complaints about outpatient medical care (appointments with local doctors, tests, ultrasounds, etc.). While only 14% of patients were not satisfied with the treatment in hospitals. And 56% said they were “satisfied to one degree or another” (in clinics this figure was 43%).

Health experts confirm this: the situation in primary (outpatient) care is certainly more complex. On the one hand, the workload of doctors is greater here. After all, the first thing we all do is go to a therapist or call a doctor at home. On the other hand, the shortage of doctors and nurses in clinics is more serious than in hospitals. Doctors themselves often admit that working in hospitals is usually more professionally interesting and the payments are higher.

Health experts confirm this: the situation in primary (outpatient) care is certainly more complex.

Photo: Artem Kilkin

SPECIFICALLY

What are patients dissatisfied with in clinics?

The 3 most common complaints look like this:

1. Waiting a long time in line in front of the doctor’s office (more than 20 minutes from the agreed time): 85%.

2. Lack of the necessary specialist in the clinic and (or) inability to make an appointment with him: 84%.

3. Inability to get all the necessary services in one place: 83.6%.

Patients also complain of the following difficulties:

– long wait to see a specialist after making an appointment (more than 14 business days as required by law): 79%;

– it is difficult to contact the clinic to make an appointment for an examination, an appointment or to obtain general information: 75.9%;

– long wait for instrumental studies – X-ray, MRI, CT, ultrasound (according to the law, the waiting period for one examination does not exceed 14 working days) – 71%.

“The rating of the most common problems was approximately the same last year,” noted Tatyana Fomina. “But fewer patients now have difficulty calling a doctor at home. In 2022, this figure was 57%, this year, 48.5%.”

As for hospitals, although they rate their work better in general (see above), Russians cite the need to purchase medicines at their own expense as the most common problem. We remind you that, according to the law, during hospital treatment, medications prescribed by a doctor must be administered free of charge.

ON TRUST IN MEDICINES AND PROTECTION OF PATIENTS’ RIGHTS

Almost one in five patients surveyed (18.4%) said they were dissatisfied with the attitude of medical staff, including “inappropriate behavior of medical workers.” It must be taken into account that patients, due to their complex situation, do not always justifiably blame doctors and nurses, experts say. In general, about half of patients trust doctors (to one degree or another they are satisfied with their treatment). The participants in the round table admitted that serious work is needed to increase this indicator. It is known that the success of treatment depends 30-50% on mutual understanding between the doctor and the patient.

Experts also noted that more and more people are willing to defend their rights if they encounter problems when trying to obtain medical care. “It’s time to stop believing the myth that doctors will “get revenge” if you complain about them. Practice constantly confirms this: this is not so. If patients whose interests are violated turn to their health insurance organizations for help, they will be treated more carefully in the future. And the medical care is of better quality,” highlighted Alexey Starchenko, president of the National Agency for Patient Safety and Independent Medical Expertise.

BY THE WAY

According to the study, when they have problems obtaining medical care, Russians most often go to the management of a clinic or hospital (34%). Or they contact the insurance company that issued the compulsory health insurance policy (29%). We remind you that insurers are authorized by law to help protect patients’ rights.

Thirdly, there are complaints to the Ministry of Health. The fourth, to the regional health authorities. The fifth, to the prosecution.