Forecasting the total expenditure on healthcare in the Russian Federation

The general expenses are defined as money needed to provide for the functioning of healthcare system from all sources - public and private. In this article the author proposes a methodical approach to defining total expenditure on healthcare. The important feature of this approach is that it enables us to combine official Russian and international data. As a source of data for the definition of public expenditures the data from Russian Federal Treasury are used. Private expenditures are determined according to the statistical data of the World Health Organization in so far as they refer to the share of public expenditures in the total expenditure on healthcare. The last actual WHO data for 2012 show the share of public expenditures in Russia of 61,0%; the other part of the total expenditures relates to various private sources of financing, therefore it is not difficult to estimate the size of the total expenditures. However, such a biennial lag of official WHO data leads to a problem that can be solved with one of the extrapolation methods. The proposed method consists in forecasting public expenditure on health care based on official data. On the basis of this forecast the most accurate methods of extrapolation are chosen. Then these methods are applied to create a forecast for the total expenditure. Simultaneously, hypothesis is made: since the total expenditure on healthcare is directly dependent on public expenditures, any extrapolation method applied to forecast public expenditure on healthcare in Russia's modern financial and economic conditions is applicable for forecasting the total expenditure on health care in the Russian Federation. The following three main methods of extrapolation were analyzed: the method of the moving average, the method of exponential smoothing (two options) and the least square method. As a result, the methods of exponential smoothing were rejected as inappropriate because even for the medium-term forecast; they showed a critical average relative error (up to 154.6% by the first option). Thus, the forecast of the total expenditure was created on the basis of the methods of the moving average and the least squares. Comparing the results of the forecast of financing of Russian healthcare estimated with two methods, it is obvious that the moving average method at the set parameters has the highest forecast precision (the average relative error is 6.0%). However, the author's opinion is that the obtained data are pessimistic because the forecast till 2020 actually shows the scenario of stagnation (year 2013 -3400 billion rubles, year 2020-3432.8 billion rubles). It does not show the real picture. Even if public expenditure on health care decreases, private expenditure will grow to replace the state ones, which will result in growth of the total expenditure on healthcare. This dynamics corresponds is more related to the forecast made with the least squares method (year 2013 - 3709.4 billion rubles, year 2020 -5829.7 billion rubles; the average relative error corresponds to the good forecast accuracy - 19.8%). Thus, the hypothesis was not confirmed. Theoretically, both the methods can be used for forecasting. However, if we want to obtain the most probable result in the actual financial, economic, medical and social condition of the Russian healthcare system, it is necessary to deal with the obtained data very judiciously. Therefore, despite the fact that the total expenditure, according to the proposed method, functionally depends on public expenditures, the extrapolation methods applied to public expenditures cannot correctly show the forecast of the total expenditure on Russia's healthcare.

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