At the outpatient/polyclinic level, the social care service and inpatient-type home care are underdeveloped, and continuity of treatment between inpatient there have also been annual targets for the funding of medical care per person (per capita funding targets). .
Regional state guarantee programs were implemented in 60 federal regions of the Russian Federation in 2007, with a deficit of 65.4 billion rubles). Deficits in the funding of regional mandatory health insurance (MHI) programs were recorded in 58 federal regions of the Russian Federation (29.2 billion rubles). MHI funds are channeled to treatment facilities via private insurance companies that are not interested in improvements in the quality of medical care or reductions in the cost of medical care delivery. Additional channels for funds are private medical care and voluntary health insurance (VHI) programs. The existence of these sources allows medical institutions to obtain additional funding. However, given the lack of regulation for these services, it also reduces the availability and quality of medical care for people under the state-guarantee program. Russia's medical care system comprises both self-sufficient and poorly integrated outpatient/polyclinic, emergency, and inpatient services. Medical care is delivered to the population at nearly 5,993 hospitals, 7,951 health centers, 2,330 outpatient/polyclinic institutions, and 827 dental clinics. Despite a developed network of outpatient/polyclinic institutions, the current system for the provision of primary medical assistance is not capable of meeting the needs of the country's population and modern society. Poor organization of the work of district-level doctors and current pay arrangements prevent primary healthcare providers from doing their main job: preventing disease. Despite the introduction of financial rewards for increases in the provision of medical care to the population by primary healthcare providers, there has not been a material redistribution of the healthcare burden from specialists to primary healthcare providers.
