The Healthcare System of Ukraine reforming: the important tasks of the current stage

Authors

  • I.V. Yakovenko Boris Grinchenko Kyiv University, Kyiv, Ukraine
  • A.V. Tsarenko Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine; International public organization "International Association "Health of Society", Kyiv, Ukraine
  • S.V. Tikhonenko Boris Grinchenko Kyiv University, Kyiv, Ukraine

DOI:

https://doi.org/10.22141/2306-2436.9.4.2020.219250

Keywords:

health care reform, health care facilities funding mechanisms, regulatory framework, socio-medical centers, primary health care, secondary and tertiary health care, health care insurance

Abstract

Background. Purpose of the study was to discuss and determine the optimal approaches and solutions to the crisis situation to ensure the financial accessibility of the population of Ukraine to secondary and tertiary medical care in the context of the Healthcare System reforming and the Covid-19 pandemic fighting. Materials and methods. Regulatory-legal acts, sources of scientific literature; research methods: system approach, system analysis, comparison and generalization. Results. An analysis of the Healthcare System reforming model indicates a significant shortage of the medical sector funds. The financial crisis in the health sector was also affected by a significant reallocation of funds in favor of primary health care (PHC). To remedy this situation, it is necessary to involve United Territorial Communities (UTC) in financing medical care, including to give to the UTC the right to pay for treatment of community residents at the expense of local budgets. It is necessary to develop a special mechanism for medical care for patients with chronic diseases. It is advisable to convert some part of healthcare facilities (HCF) into social and medical centers, where chronic patients, including palliative patients, will be able to receive planned maintenance therapy and rehabilitation, and in certain situations, even isolation. These may be nursing facilities that focus on physician prescriptions fulfilling, psychological and social support, and spiritual guidance. Another important and painful issue is the future of the leading medical centers and clinics of the National Academy of Medical Sciences of Ukraine, the Ministry of Health of Ukraine and the State Administration Affairs. Many areas of the Healthcare System reforming require drastic measures to correct previously launched mechanisms, as well as the innovative approaches introduction. Conclusions. The analysis of the current situation of the Health Guarantee Program within the framework of healthcare reform implementation has revealed significant shortcomings in the legal framework and mechanisms for financing secondary and tertiary health care. It is necessary to introduce changes in the organizational model of PHC, where the main link should be a family medicine ambulant clinic as a legal entity. Innovative approaches and additional sources of health care funding should be implemented. This requires additions to the current legal framework, which would take into account the shortcomings of the health care reform current model and the experience of the regions.

References

Про схвалення Концепції реформи фінансування системи охорони здоров’я. Розпорядження Кабінету Міністрів України від 30 листопада 2016 р. № 1013-р. – URL: https://zakon.rada.gov.ua/laws/show/1013-2016-%D1%80#Text.

Закон України «Про державні фінансові гарантії медичного обслуговування населення» від 19 жовтня 2017 року, № 2168-VIII. – URL: https://zakon.rada.gov.ua/laws/show/2168-19#Text.

Наказ МОЗ Украпїни від 29.07.2016 № 801 «Про затвердження Положення про центр первинної медичної (медико-санітарної) допомоги та положень про його підрозділи (Зареєстровано в Міністерстві юстиції України 22 серпня 2016 р. за № 1167/29297). – URL: https://zakon.rada.gov.ua/laws/show/z1167-16#n8.

Деякі питання реалізації програми державних гарантій медичного обслуговування населення у 2020 році. Постанова Кабінету Міністрів України від 05 лютого 2020 р. № 65. – URL: https://www.kmu.gov.ua/npas/deyaki-pitannya-realizaciyi-programi-derzhavnih-garantij-medichnogo-obslugovuvannya-t050220.

Белец Ж. Державне регулювання застосування програмно-цільового методу бюджетування в практиці розвинених країн світу / Ж. Белец // Зб. наукових праць «Ефективність державного управління». – 2014. – Вип. 39. – С. 295-302.

ВООЗ. Україна: огляд реформи фінансування системи охорони здоров’я за 2016-2019 роки. Спільний звіт ВООЗ та Світового банку. – ВООЗ, 2019. – 98 с.

Published

2020-10-01

Issue

Section

Мedicine