The Effects of Changes in the Health System on the Health of the Population: A Natural Experiment in the Countries of the Former Soviet Union
Salma Haidar, Ph. D., MPH; Nailya Delellis, Ph. D., MPH; Lindsay Soave, BS

This descriptive study views the collapse of the Soviet Union in 1991 as a unique natural experiment to study the effect of changes of healthcare system on health and healthcare outcomes in the 15 post-soviet countries. The study utilized secondary data obtained from the World Bank. Data collected included indicators of health and lifestyle (e.g., life expectancy, birth rate, infant mortality rate), healthcare (e.g., number of physicians, health expenditure, number of hospital beds), and socio-economic development (e.g., GDP, outof- pocket expenditure). Countries were divided into “Private” or “Public” health systems based on their public health expenditure percentage. Although there was no major shifts in the patterns over time, regression analysis showed that countries with a private healthcare system tended to have higher infant mortality rate (standardized b=0.158, p<0.01) and lower total life expectancy (standardized b=-0.096, p<0.01). As healthcare systems continue to evolve, it is important to examine the effects of health system changes on health outcomes. Our results showed that no single system in the post-soviet countries presented superior outcomes on all health domains; rather, each system had individual strengths and weaknesses. However, more research is required to examine the effect of health systems on the population health.

Full Text: PDF     DOI: 10.15640/ijhs.v3n4a3