Science / Medicine : Soviet Hospitals Competing

An attempt to introduce competition for patients at Moscow’s teaching hospitals is one Soviet health system reform that appears to be making headway under President Mikhail S. Gorbachev’s economic restructuring plan. On a visit to Los Angeles, the chief of the All-Soviet Surgical Research Center, Dr. Boris Konstantinov, said his institute can no longer depend solely on the government for financing.

He said the various centers now compete for contracts to earn extra money by providing care to factory workers. The factories pay according to the complexity of the surgery, and the money is used to buy better equipment and to increase the pay of doctors who work hard and do good surgery, Konstantinov told a group of heart surgeons at St. Vincent Medical Center. The use of competition to improve the image and quality of the system is one of many innovative approaches announced 18 months ago by Yevgeny Chazov, health minister.

Until recently, death rates had been rising and life expectancies decreasing in the Soviet Union. Although the people have been demanding more consumer goods and improved health care, recent news reports indicate that Chazov is encountering stiff resistance from bureucrats in implementing reforms.

Konstantinov and Dr. Sergei Dzemeshkevich, chief of heart transplantation visited California as part of a USC School of Medicine exchange program.