Russian experience in healthcare quality assurance through standards of care: 2014–2023

OBJECTIVES: The Russian Federation inherited from the USSR a vast and poor healthcare system. Since 1996, the move to evidence-guided care has been initiated. The objective is to describe the last 10 years' significant progress in the development of the centralised system of guidelines and quality assurance. METHODS: For the narrative review, we searched MEDLINE and the Central Medical Library, Moscow for reports relevant to the quality of healthcare and used our collections of the grey literature for the policy review. Neither patients nor the public were involved in the design and execution of this study. RESULTS: Legislation 2011 recognised clinical practice guidelines (CPGs) as an important tool in developing evidence-based practice. On top of the system are regulations of a new type-orders of medical care-which prescribe the patients' track in the healthcare system, as well as the necessary staffing and equipment for participating organisations. CPGs describe the recommended interventions. Third, documents called 'standards' are derived from CPGs to calculate the average cost for costing diagnosis related groups and informing other payment decisions. At the same time, the Ministry of Health promotes the certification of medical organisations and introduces lean at the outpatient facilities. The criminal prosecution of physicians became more frequent, disturbing the profession. CONCLUSIONS: A wide range of initiatives in quality assurance promise improvement in the quality of health care. Unfortunately, the insufficient and reduced funding, as well as solutions with unknown effectiveness, may limit prospects for improvement.