Disparities in budgetary funding of regional healthcare systems as a factor in unequal access of the population to free medical care

Aim . This work aimed to assess the relationship between budgetary funding of the regional healthcare system and population expenditures on paid medical services in the context of ensuring equal access to free medical care. Objectives . We seek to identify the structure of consolidated regional budget expenditures using the Northwestern Federal District as an example; analyze the dynamics of budgetary funding of healthcare and population expenditures on paid medical services; and determine the parameters of interregional disparities in the funding of medical services from the budget and at the expense of the population, as well as ways to reduce interregional differences in budgetary funding of healthcare to ensure equal access of the population to medical care. Methods . A set of scientific methods based on a systems approach was applied. The work employed statistical analysis of dynamic data series, grouping and comparison methods, classical inferential analysis, and content analysis of secondary sources. Results . Interregional differences in budgetary funding of healthcare that create barriers to ensuring equal access to quality medical care for population were identified and quantified. Interregional differences in the share and dynamics of healthcare expenditures in the consolidated regional budget were assessed, as well as differences in the direction of changes in healthcare funding in the consolidated regional budget, differences in the specific expenditures of the consolidated regional budget on healthcare per capita, and differences in the ratio of the share of population expenditure on medical services to the share of expenditures on the healthcare system from the consolidated regional budget. Conclusions . Regional differences in budgetary investments in healthcare can be considered one of the factors contributing to unequal access to free medical care for residents of different regions. Reductions in budgetary expenditures on public health support are forcing citizens to increase healthcare expenditures at the expense of other family budget items. The state is aimed to equalize disparities in regional healthcare funding, and additional opportunities for this are opening up with the launch of the new priority project Long and Active Life.