[The health capital and efficiency of regional health care systems: The conformances and contradictions].

The article explores relationship between health capital and efficiency indices of regional health systems. The correlation analysis of relationship between individual subjective assessments of health capital and objective indices of health care system functioning in the regions and the Federal Okrugs of the Russian Federation based on application of Minmax technology was carried out. The determination of level of health capital was implemented according to results of population survey and subsequent modeling. The effectiveness of regional health care systems was assessed using indices of healthy life expectancy, percentage of the disabled and per capita health care expenditures in the regions. It is established that 1/3 of subjects of the Russian Federation have high level of health care efficiency. However, the high level of health capital was noted in 12.5% of subjects, while in 40% of them its level was low. There are pronounced regional differences in the stock of health capital. The highest level of health capital was established in the subjects of the North Caucasian Federal Okrug that is conditioned by higher healthy life expectancy and higher efficiency of health care system at lower per capita costs. The statistically significant differences between subjective and objective factors affecting assessment of health capital are presented. The lower per capita health care costs and high percentage of the disabled have no significant impact on health capital of the population in the regions of Russia. The differences between health capital and regional health system performance indices are conditioned by subjective nature of health capital estimates that are determined by individuals within social groups and are characterized by persistent systematic differences between regions.