Abstract

BACKGROUND: The relevance of this study lies in the systematic analysis of scientific and methodological approaches to the study and evaluation of health care as a multidimensional and multi-level system.
 AIM: To systematize methodological approaches to the study of the effectiveness of the health care system in the Russian Federation.
 MATERIALS AND METHODS: A retrospective categorical analysis of original studies belonging to the genre scientific article and devoted to the effectiveness (quality) of the health care system in Russia, published in domestic scientific periodicals from the period 2011 to 2021, was carried out. The categorical analysis included the following parameters: healthcare system, efficiency, methods and revealed 144 publications. The usual selection process excluded 17 publications. Based on the inclusion and exclusion criteria, 48 sources were selected. All original studies were divided into either medical and non-medical according to the author's specialization. The analysis allowed for the revelation and parameterization of scientific-methodological tendencies of researches on public health effectiveness according to statistical-structural-dynamic characteristics of researches and specialization of the author (medical and non-medical specialization). The main methods used in the original research were analyzed.
 RESULTS: The structure of the scientific publications was dominated by the results of original research (64%). No systematic reviews and meta-analyses were identified. The increase in the dynamics of publication activity on the stated topic was due to original research. Most of the trials were conducted at the meso-level (70.8%). There were virtually no works devoted to the results of original research conducted at the countrywide level. A set of sociological, medical-statistical and economic methods was used as the main research tool for studying efficiency. Sociological methods and approaches for analyzing official medical statistics prevailed in pure form. Demography and mathematical modeling methods were the least used. No quantitative differences were found in the authors' specialization. Differences in the authors' gravitation toward the study of different types of efficiency were observed depending on the researchers' specialization, as well as the frequency of studies on economic and social efficiency in their study at the meso- and macro-level and the use of methodological apparatus in the study of these types of efficiency.
 CONCLUSION: The core of the publication activity is formed by the results of original research obtained at the meso-level, with research conducted at the macro-level being practically absent. Systematic reviews and meta-analyses were completely absent. There was homogeneity in the use of different types of effectiveness research methods. The findings of this study suggest that there is a practical need for quantitative and qualitative systematization of the experience gained in studying health system efficiency, particularly at the national level, as a prerequisite for effective planning of its development.

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