Overview of the existing opportunities and limitations of the state guarantees program for provision of free medical care to citizens

Introduction. The state guarantee program for provision of free medical care to citizens is a key regulatory document that describes the actual guarantees of citizens for medical care. The standards of the extent and financing of medical care established in it, determine the level of state guarantees throughout the Russian Federation. The aim is to determine possible limitations of the state guarantee program within the formation of indicators for the extent of medical care provided in the regions of the Russian Federation and the corresponding financial support. Materials and methods . As part of the study, the federal and regional regulatory legal acts were analyzed, in terms of the methodology for the formation of regional programs of state guarantees, the extent of medical care and financing, as well as the methodology for the formation of these standards. Results. The existing mechanisms for adapting the federal program of state guarantees at the regional level have been identified, and it has been shown that in most regions of the Russian Federation these methods are not used. Objective criteria for differentiating the standards of medical care exist in 77 regions, these standards correspond to the federal level in the vast majority of the regions of the Russian Federation, however there is a financing gap of the territorial programs in 2017 using the regional budget in 70 regions of the Russian Federation. Findings. The current recommendations on formation of the territorial program of state guarantees are applied to a limited extent. Calculation of the per capita financing standard for a region of the Russian Federation depends only on the differentiation coefficient; incidence rate, age and gender structure of population in a region are not taken into account while calculating the subvention amount.