UDC: 336
https://doi.org/10.25198/2077-7175-2026-4-26


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DEMOGRAPHIC CHANGES AS A FACTOR IN THE TRANSFORMATION OF HEALTH INSURANCE (ON THE EXAMPLE OF THE VOLOGDA REGION)

С. S. V. Aksyutina1, A. A. Borisov2
Vologda State University, Vologda, Russia
1 e-mail: s_vasilievna@mail.ru
2 e-mail: borisovaa@vogu35.ru

Abstract. The relevance of the study is determined by the fact that the current challenges of medical insurance are shaped by negative demographic processes, manifested in the annual decline of the population due to the excess of mortality over the number of births, an increase in morbidity in the Vologda region exceeding the all-Russian average, a shortage of medical personnel, and a weak insurance culture among the population, which hinders the development of the voluntary medical services insurance market. These factors necessitate the introduction of new mechanisms for financing medical care, including both compulsory and voluntary medical insurance.

The aim of this work is driven by the need to identify ways to develop voluntary medical insurance, taking into account the identified medical and demographic trends in the Vologda region, given the limited financial base of compulsory medical insurance.

The research methodology is based on the application of theoretical and empirical methods. Through the analysis of empirical data and synthesis of theoretical approaches to improving healthcare via compulsory and voluntary insurance, a quantitative comparative assessment of the most significant healthcare indicators and their funding in the Vologda region was conducted. The specifics of the regional voluntary medical insurance market were examined, and pathways for its development were proposed.

The authors found that the resources of compulsory medical insurance are insufficient to ensure citizens’ interests in health protection, with a regressive trend observed in the region’s medical and demographic indicators. An increase in mortality, a decrease in birth rates, a rise in morbidity, and a shortage of medical personnel were noted. The analysis revealed an increase in financial provision for compulsory medical insurance alongside insufficient efficiency of the medical insurance system in the region. Currently, there is a focus on the corporate segment in commercial medical expense insurance, which implies the expansion of voluntary medical insurance and the implementation of new models based on an individual approach to protecting citizens’ health interests. The study demonstrates the potential for developing combined products of compulsory and voluntary medical insurance, enabling citizens to choose a healthcare provider and receive qualified, high-quality care.

The scientific novelty of the research lies in advancing ideas on improving healthcare quality through attracting resources from voluntary medical insurance, as well as substantiating key components in the foundation of regional healthcare, such as the transition from disease-oriented medicine to health-oriented medicine and the formation of self-preserving behavior among citizens.

The results obtained can be applied in scientific medical and demographic research, by government authorities for improving and regulating medical insurance, and by insurance business representatives for developing health insurance products. In the future, the findings will be used to model a system of regional compulsory and voluntary medical insurance.

Key words: healthcare, demographic indicators, medical insurance, voluntary health insurance programs, insurance culture.

Cite as: Aksyutina, S. V., Borisov, A. A. (2026) [Demographic changes as a factor in the transformation of health insurance (on the example of the Vologda region)]. Intellekt. Innovacii. Investicii [Intellect. Innovations. Investments]. Vol. 4, pp. 26–38. – https://doi.org/10.25198/2077-7175-2026-4-26.


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