PRIMARY MEDICINE FUNDING: REALITIES AND PROBLEMS OF IMPLEMENTATION OF THE BRITISH EXPERIENCE IN UKRAINE

Oksana TULAI, Sviatoslav NYTKA

Анотація


Introduction. In Reforming Ukraine’s health care system involves distinguishing between primary, secondary and tertiary levels of health care, as well as determining the list of services to be provided at each of these levels. Ukraine will have to adapt its chosen model of health care financing to national priorities and ensure the availability of health care. Copying any foreign model without taking into account domestic peculiarities and economic justification will inevitably be accompanied by significant risks and will not lead to the expected results. Taking into account the outlined aspects, the issue of implementation of the British experience of financing primary health care in Ukraine is topical.

The purpose of the article is to monitor current trends, identify and analyze problems related to the implementation of the British experience in the system of financing primary health care in Ukraine.

Results. The study showed that in the process of reforming Ukraine’s health care financing system, primary health care will undoubtedly be a priority for public funding. The process of implementation of the British model of financing PMD, as expected, has created certain difficulties and problems that require systematic scientific analysis and neutralization of the risks of negative impact on social development. It must be acknowledged that the difficulties in implementing PMD reform are a normal world practice, and budgetary constraints on the financing of the primary care system of Ukraine are an incentive for the NHS to target and rationally allocate budget funds.

Conclusions. The cornerstone of the “money follows the patient” reform principle has not been implemented at the primary care level. A problematic aspect of the PHC reform is that in 2018–2020 the NSSU did not perform the function of an organization engaged in strategic procurement of quality primary health care services for the benefit of Ukrainian citizens, but acted exclusively as an organization concluding contracts with medical institutions. We consider debatable the expediency of applying the capitation rate, which clearly does not encourage the family doctor to provide the maximum possible amount of medical care to the patient, but creates a “transfer of responsibility” to narrow specialists. In our opinion, in the logistics of PMD reform, the principle of “money follows the patient” should be replaced by the basic financial model of “money follows services”, which demonstrates the fundamental aspects of the new reform paradigm for public procurement of medical services.


Ключові слова


financing, budget funds, health care, primary health care, reform

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Посилання


Krynychko, L., Motailo, O. (2021). Novi pidkhody do finansuvannia systemy okhorony zdorovia [New approaches to health care financing]. Aspekty publichnoho upravlinnia – Aspects of Public Administration, 2, 86–100 (Vol. 9) [in Ukrainian].

Drahunov, D. M. (2021). Finansovi instrumenty stratehichnoho rozvytku sfery okhorony zdorovia v umovakh tsyfrovoi ekonomiky [Financial instruments of strategic development of health care in the digital economy]. Natsionalnyi universytet “Chernihivska politekhnika” – National University “Chernihiv Polytechnic”, Chernihiv [in Ukrainian].

Chorna, V. V. (2021). Porivnialnyi analiz finansuvannia sfery okhorony zdorovia Ukrainy ta krain Yevropeiskoho Soiuzu [Comparative analysis of health care financing in Ukraine and the European Union]. Visnyk sotsialnoi hihiieny ta orhanizatsii okhorony zdorovia Ukrainy – Bulletin of Social Hygiene and Health Care Organization of Ukraine, 1 (87), 45–49 [in Ukrainian].

Lekhan, V. M., Kriachkova, L. V., Zaiarskyi, M. I. (2018). Analiz reform okhorony zdorovia v Ukraini: vid zdobuttia nezalezhnosti do suchasnosti [Analysis of health care reforms in Ukraine: from independence to the present]. Zdorovia natsii – The Health of the Nation, 4 (52), 5–11 [in Ukrainian].

Belaniuk, M. V., Radziievska, O. H., Manhora, T. V. (2019). Transformatsiia systemy okhorony zdorovia v Ukraini [Transformation of the health care system in Ukraine]. Informatsiia i parvo – Information and Law, 4 (31), 119–128 [in Ukrainian].

Barzylovych, A. D. (2020). Reformuvannia systemy okhorony zdorovia v Ukraini: stratehichni aspekty [Reforming the health care system in Ukraine: strategic aspects.]. Investytsii: praktyka ta dosvid – Investments: Practice and Experience, 2, 134–140 [in Ukrainian].

Pro zatverdzhennia Poriadku nadannia pervynnoi medychnoi dopomohy. Nakaz Ministerstva okhorony zdorovia Ukrainy vid 19.03.2018 r. N504 [On approval of the Procedure for providing primary medical care. Order of the Ministry of Health of Ukraine]. (2018, March, 19). Available at: http://moz.gov.ua/uploads/0/4207-dn_20180319_504.pdf.

Pro skhvalennia kontseptsii reformy finansuvannia systemy okhorony zdorovia. Rozporiadzhennia Kabinetu Ministriv Ukrainy vid 30.11.2016 r. N1013-r. [On approval of the concept of health care financing reform. Order of the Cabinet of Ministers of Ukraine]. (2016, November, 30). Available at: https://zakon.rada.gov.ua/laws/show/1013-2016-%D1%80#Text.

Oplaty nadavacham medychnoi dopomohy za prohramoiu medychnykh harantii [Payments to medical care providers under the medical guarantee program]. Natsionalna sluzhba zdorovia Ukrainy: e-Dani – National Health Service of Ukraine: e-Data. Available at: https://nszu.gov.ua/e-data/dashboard/pmg-pay.

Zvit pro rezultaty audytu efektyvnosti vykorystannia koshtiv derzhavnoho biudzhetu, vydilenykh Natsionalnii sluzhbi zdorovia Ukrainy na pervynnu medychnu dopomohu. Rishennia Rakhunkovoi palaty vid 25.05.2021 N11-3 [Report on the results of the audit of the effectiveness of the use of state budget funds allocated to the National Health Service of Ukraine for primary health care. The decision of the Accounting Chamber]. (2021, May, 25). Available at: http://www.rp.gov.ua/upload-files/Activity/Collegium/2021/11-3_2021/Zvit_11-3_2021.pdf.




DOI: https://doi.org/10.35774/sf2021.04.039

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