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Journal Regional Economy -- re2018.01.076

Repository of Institute of Regional Research Repository of Vernadsky Library UDC 336.5:[338.46:61]:614.2; JEL H35, H72, I13
Dub, A. R. (2018). Transformatsiya mekhanizmu finansuvannya okhorony zdorovya: vyklyky dlya obyednanykh terytorial'nykh hromad [Transforming of the health financing mechanism: challenges for the united territorial communities]. Rehional'na ekonomika - Regional Economy, 87 (1), 76-84. Retrieved from http://re.gov.ua/doi/re2018.01.076.php. [in Ukrainian].
Sources: 8

Authors



Dub Andriy Romanovych

Ph.D. of Economics, Associate Professor

Senior Researcher of the Department of regional financial policy of the Dolishniy Institute of Regional Research of NAS of Ukraine

Contacts: a_dub@lnu.edu.ua

Webpages:

Resume

Improving the quality of health care delivery is the goal of medical reform. However, the transformation of the financing mechanism of health care should become the breakthrough in its accomplishment. Particularly, the issues of medical reform financing are of utmost importance for the communities formed in the process of decentralization of power, since in 2018 the changes will affect the primary level of provision of medical services.
The purpose of the article is to identify potential problems and risks of public health financing transformation at the level of the united territorial communities.
The process of transforming the health financing mechanism in 2016-2017 is examined. The adequacy of funds allocated from the state budget to ensure the functioning of medical institutions providing primary health care in the united territorial communities in Lviv region is analyzed. The possible financial and social risks of introducing a new approach to financing primary health care in 2018 are critically assessed.
The budget financing of health care through the use of medical subvention is imperfect and needs reform. An analysis of the use of medical subventions to finance the provision of primary health care at the united territorial communities’ level in 2016 showed that funds allocated from the state budget remained unused in some communities, while others lacked them. The main reasons were: the imperfection of the formula for distributing the medical subvention and the distrust of the population to the medical staff in the primary health care institutions in rural areas due to their low professional level. Changes in the financing mechanism of health care in 2017 did not correct the situation. In 2018, healthcare financing based on the principle of “money going for a patient” will be launched at the level of primary care provision. Despite this, there is a threat of emergence of a number of risks, both financial (the sufficiency of funds to finance medical services and investment expenditures for the development of a network of medical institutions, etc.), as well as of social nature (quality and timeliness of provision of medical services, provision of medical institutions in rural areas, etc.).
The need to reform the financing mechanism of the health care sector is beyond doubt. But, besides this, it is accompanied by a significant amount of both financial and social risks that may have an impact on the effectiveness and efficiency of the reform, especially in rural areas. Therefore, related issues will require in the near future a detailed study and development of measures to eliminate them.

Keywords:

budget, medical subvention, health care, united territorial community, medical reform

References

    
  1. State Statistics Service of Ukraine (2017). Zaklady okhorony zdorov'ya ta zakhvoryuvanistʹ naselennya Ukrayiny u 2016 rotsi [Establishments of health care and morbidity of the population of Ukraine in 2016] (Statistical Bulletin). Kyiv. [in Ukrainian]. Retrieved from http://www.ukrstat.gov.ua/druk/publicat/kat_u/2017/bl/06/bl_zoz_2016.zip [in Ukrainian].
  2. Ushynina, T., & Sytnik, O. (2016, Jan 19). Chek-list reform. Zastupnyk ministra okhorony zdorov"ya pro te, shcho robyt' MOZ, choho nam chekaty i koly [Check-list of reforms. Deputy Minister of Health on what the Ministry of Health does, what to expect and when] // Ukrayinska pravda: Website. Retrieved from http://life.pravda.com.ua/health/2016/01/19/206647 [in Ukrainian].
  3. Supreme Council of Ukraine (2017). Bjudzhetnyj kodeks Ukrainy [Budget Code of Ukraine]. Adopted on 2010, July 8, 2456-VI. Retrieved from http://zakon0.rada.gov.ua/laws/show/2456-17 [in Ukrainian].
  4. Cabinet of Ministers of Ukraine (2015). Dejaki pytannja nadannja medychnoï subvencii z deravnoho bjudzhetu miscevym bjudzhetam [Some issues of providing medical subventions from the state budget to local budgets]. Resolution on 2015, January 23, 11. Retrieved from http://zakon2.rada.gov.ua/laws/show/11-2015-п/paran74#n74 [in Ukrainian].
  5. Supreme Council of Ukraine (2016). Pro derzhavnyy byudzhet Ukrayiny na 2017 rik [On the State Budget of Ukraine for 2017]. Law of Ukraine, adopted on 2016, December 21, 1801-VIII. Retrieved from http://zakon3.rada.gov.ua/laws/show/1801-19 [in Ukrainian].
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  7. Romanenko N. (2017, November 11). Komu prinadlezhat chastnyie kliniki Ukrainy [Who owns private clinics in Ukraine]. Website Biz.Censor. Retrieved from https://biz.censor.net.ua/resonance/3035914/komu_prinadlejat_chastnye_kliniki_ukrainy [in Ukrainian].
  8. Ministry of Health of Ukraine (2013). Pro zatverdzhennya Normatyviv zabezpechenosti merezheyu ambulatoriy – pidrozdiliv tsentriv pervynnoyi medychnoyi (medyko-sanitarnoyi) dopomohy [On Approval of the Provisions for Provision by the Network of Outpatient Departments – units of the centers of primary medical (medical-sanitary) care]. Ministry Decree on 2013, September 10, 793. Retrieved from http://zakon3.rada.gov.ua/laws/show/z1587-13 [in Ukrainian].

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