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Diagnostic card: does it exist in Russia has a shortage of clinics for laboratory research
In Russia, depending on the region, the number of clinics and laboratories that provide medical diagnostic services differs dramatically — the gap between megacities and some cities reaches hundredfold values. The ability to receive timely laboratory diagnostics is one of the important indicators of the availability of medical care, which should also affect the early detection of diseases. However, experts urge not to focus on this issue on a dry calculation of the number of medical institutions that provide medical research services — other factors are also important. Izvestia has learned about the sharp differentiation in the availability of laboratory diagnostics between regions.
"Drastic differentiation of accessibility"
The Deacon Group of companies and the Progress communication group conducted a study in 45 cities with a population of more than 300 thousand people (available to Izvestia) on the availability of laboratory diagnostics. The number of clinics that provide similar services to patients was estimated. The analysts took into account both private and public medical institutions and laboratories.
It turned out that there is a "sharp differentiation in the availability of medical infrastructure in the regions": the difference in the number of clinics performing in-demand tests between Moscow and individual cities is more than 100 times. In particular, if there are 2,537 such institutions in the capital, then there are only 17 in Yakutsk.
St. Petersburg was expected to take the second place in the rating, although it is more than twice as large as Moscow in terms of the number of clinics, with 1,068 medical organizations providing services there. After the two largest megacities, there is a sharp decrease in indicators: in Novosibirsk, there are 248 such medical institutions, in Nizhny Novgorod — 210, in Rostov-on-Don — 201. Most of the studied cities range from 50 to 150, and the minimum values, in addition to Yakutsk, are recorded in Surgut (21), Novokuznetsk (22) and Kaluga (24).
The maximum saturation of the market (about 18-20 clinics per 100,000 population) is in Orenburg, Moscow, St. Petersburg, Vladivostok and Rostov-on-Don. The minimum number (4-7 clinics) is in Novokuznetsk, Yakutsk, Surgut and Kaluga. At the same time, high competition in Moscow and Krasnodar did not lead to lower prices, unlike in Vladivostok, where, with this in mind, the average price of analysis is one of the lowest in the country.
The study notes that regions also face a limited list of available studies, especially in the segment of specialized analyses. A good blood test can be done everywhere, but taking a biomaterial to specialized allergy panels is already a problem for some cities. The lowest coverage was recorded for tests for respiratory (720 clinics) and food allergens (925 clinics). Comprehensive studies on hormonal (1,067) and androgenic (1,406) profiles are also presented in a limited number of medical centers.
The average price of tests in the capital turned out to be even lower than in a number of regions. Moscow is in third place in this ranking, St. Petersburg is in fifth. Chita, Sochi and Krasnodar are among the leaders, and the cheapest tests are in Vladivostok, Lipetsk and Ryazan.
"In a number of small towns, we see abnormally high prices, which may be due to the complex logistics of biomaterials or the monopolization of the local market," Andrey Varivoda, Chairman of the Board of Directors of Deacon Group, told Izvestia.
The most expensive test turned out to be food allergen samples, which cost almost 10,000 rubles on average, while blood glucose can be tested for just 219 rubles. Analysts emphasize that transparent and strict pricing has been established in basic diagnostics, but complex studies remain a highly variable area.
Why is there such a big gap?
A large number of laboratories in a particular city only indicates that there are people living in it who are willing to pay for tests, even if they are not actually required in such numbers, said Guzel Ulumbekova, rector of the Higher School of Healthcare Organization and Management.
"This is evidence of overdiagnosis and possibly self—diagnosis," she told Izvestia.
At the same time, the expert notes that Russian state laboratories have a fairly high throughput capacity, which, most likely, has not even been fully developed.
In addition, the study compares urbanistically unequal regions, adds Elena Zakharova, head of the laboratory diagnostics project at the Be Healthy clinic network. It also does not take into account the number of unregistered residents of Moscow and residents of other regions who use diagnostics in medical centers in the capital.
In turn, Yegor Batyrev, a psychiatrist and narcologist, an assistant at the Department of Psychiatry and Medical Psychology at RUDN University, recalls that 20 years ago, state laboratories and several private organizations were mainly involved in performing tests, but now laboratory diagnostics has become a profitable franchise.
— At some point, the major players in this market realized that there is a huge demand for affordable and fast tests that can be taken within walking distance from the place of residence and at the same time without encountering queues. At the beginning of their journey, the future giants of this business independently opened blood collection points, then they began to delegate the opening of treatment rooms to investors and those who want to have passive income from an established business," the Izvestia interlocutor clarifies.
According to him, only one laboratory is enough, which can be supplied with biomaterials from dozens of sampling points. It will completely cover the production needs, the expert is convinced.
— There are much fewer treatment rooms in the regions than, for example, in Moscow, but at the same time, laboratory facilities can meet the demand of the population. The only difference is in the service and the waiting time in the queue," adds Egor Batyrev.
The prevalence of laboratories directly depends on their economic feasibility for the owners, emphasizes Yan Vlasov, co-chairman of the All-Russian Union of Patients. The state has almost no influence on this process, the number of institutions for laboratory diagnostics is not limited by regulations, their development is based on market principles.
— This leads to the fact that some of the specialized research is available only in large centers, primarily in Moscow and St. Petersburg, and less often in other regions. As a result, biomaterials for such analyses are often sent by courier services to these cities, where the study is conducted. At the same time, mass, routine analyses are performed everywhere within the framework of the issued licenses," explains the interlocutor of Izvestia.
Does the number of laboratories affect early diagnosis?
Larisa Popovich, Director of the Institute of Health Economics at the National Research University Higher School of Economics, is convinced that there is no gap in the availability of medical diagnostics based solely on the number of laboratories.
— Medical organizations cover all necessary needs, and their provision with laboratory equipment is a mandatory controlled requirement. Its purchase has been going on for many years as part of national programs," she points out.
In addition, the very nature of the use of laboratories has changed: now the analyzes can be transferred to the reference centers, the expert clarifies. Therefore, the issue of the availability of qualified personnel is much more important — it is the lack of specialists in laboratory diagnostics that can lead to the loss of availability of medical tests. Errors in the organization of the work of reference centers at the regional level can also lead to problems.
There is a gap in the number of available tests, admits Elena Zakharova. But more important in this regard is the awareness of doctors about the availability of laboratory services that help in making a diagnosis, knowledge of the patient's routing capabilities and the organization of logistics for the delivery of biomaterials from remote regions.
In total, 5,000 state laboratories with a huge variety of equipment operate in Russia, Larisa Popovich adds. But their effectiveness should be assessed not by the number, but by the final result of the work: by the indicator of early detection of pathologies. These statistics vary greatly from region to region.
Information, in particular, is collected on newly diagnosed oncological diseases. If various regional factors are not taken into account, the greater their share in the region, the better the early diagnosis is. In 2024, according to the Unified Interdepartmental Information and Statistical System (EMISS), the most new cases of cancer were detected in Moscow (more than 60 thousand), St. Petersburg (almost 30 thousand) and the Moscow Region (about 33 thousand). However, when calculating this number by population, far from the most obvious regions become the leaders in detection: the Republic of Karelia came in first place (684 cases of cancer per 100,000 inhabitants), the Arkhangelsk Region came in second (655.8), and the Bryansk Region came in third (641.7). In Chechnya, the least cases of cancer were detected — 167.7. Two more North Caucasian republics, Ingushetia and Dagestan, occupy neighboring positions.
However, it is difficult to compare these statistics with data on the number of laboratory diagnostic points in terms of population: neither Petrozavodsk nor Arkhangelsk were considered in the study at all. At the same time, Bryansk, with its good detection of oncological diseases in terms of the number of clinics with laboratory diagnostics, was at the end of the rating, while Nizhny Novgorod is at the top of the table in both lists.
At the same time, there are cases when people cannot get the necessary diagnosis. In 2025, according to a study by the All-Russian Union of Patients, more than half of Russians identified delayed diagnosis as one of the health problems. Problems are hitting people with serious illnesses: according to the Patient Control movement, since the beginning of 2025, HIV-positive Russians from at least 16 regions have faced refusals to conduct tests for viral load and immune status.
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