Comparisons are made across a range of OECD and non-OECD countries and between regions (municipalities) within the Russian Federation.24 The results in both dimensions suggest that there is substantial room for improving public expenditure efficiency. Comparisons with other countries suggest that the Russian Federation’s health outcomes are similar to those achieved by some countries which spend 30 to 40% less. The results on the basis of comparisons across regions/municipalities suggest that current health outcomes could also be produced with about two thirds of the present inputs if the less efficient regions were able to emulate the most efficient ones. Some regions have been more successful than others in achieving results even though the resources at their disposal have sometimes been more modest.25 Indeed, two World Bank demonstration regions (Voronezh and Chuvash Republic) appear to have had considerable success in improving health care supply and health outcomes demonstrating that there is considerable potential for higher performance (Box 3.1).