A Political Perception of the Healthcare System: An Experience of a Monitoring Research

The topic of a political perception of healthcare system has not been studied well despite the fact that it heavily influences the political process. The current examples we have been able to see during the coronavirus pandemic. The aim of this study is to determine modern trends in Russian political perception (Moscow as the case) and the content of various components of the population attitudes (cognitive, emotional, behavioral) in this sphere (as a part of general political attitudes). The article is based on a Moscow monitoring research conducted in December 2017 - November 2018 by the authors. The method used is CAPI, the sample is 13,200 Muscovites with elements of random sampling. The sample represented the population of Moscow by age, gender, district of residence, and level of education. The research was focused mainly on the emotional component of the healthcare system image-the dependent variable was the level of satisfaction with Moscow healthcare in general. The research showed a number of factors influencing satisfaction. The first group of factors is connected with the real experience of interaction with healthcare organizations. First, it is the fact of presence of interaction (those who did not visit medical organizations in the last 5 years showed less satisfaction with them). Then it is the type of ownership: the image of healthcare system in Moscow is mainly influenced by public healthcare (mainly by ambulatory care), not private. Socio-demographic factors (gender, income, education, age) appeared to be less influential for the perception than experience. But experience was not the only factor in influencing the image of healthcare as indicated for example by the fact that satisfaction with visiting different kinds of medical organization is much higher than the overall satisfaction with the healthcare system. The research indicates that another influential factor is coverage by mass and social media. There is evidence that information about important social events, even those irrelevant to Moscow healthcare, has a huge impact on the healthcare evaluation (e.g., through changing the general emotional state of population). Other factors include the image of authority itself (public healthcare is perceived to be a state institution), political context (e.g., electoral period) and values (e.g., social justice, health). Among the given recommendations, the most important is to use the proposed model of the political perception of the healthcare system in practice, for it takes into account the complexity of the political perception process. The model shows that the level of satisfaction is not the domain of the medical governing bodies alone, the task of its improvement requires multisector coordination; it is the domain of social policy in general. This work is crucial because, as the research showed, there is a strong interconnection between the image of the healthcare system and the image of authority in Russia.

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