School of Public Health, Department of Health Policy, Medical University of Silesia in Katowice, Ul. Piekarska 18, 41-902, Bytom, Poland.
Academy of Labour, Social Relations and Tourism, 3A, Kiltseva Doroga, Kyiv, 03187, Ukraine.
Global Health. 2018 Nov 23;14(1):116. doi: 10.1186/s12992-018-0439-5.
Ukraine, one of the largest states formed on the rubble of the Soviet Union, is widely perceived as a country that has lost its opportunities. Being devastated by corruption, it shows incapable to modernize and enter the economic path of sustainable growth. Similarly in the health care system no deeper reform efforts have been taken in the entire post-soviet period, leaving the system in bonds of ineffective solutions taken out of the Soviet era.
The recent geopolitical and economic crisis seem to favor the introduction of radical solutions that might lead to a rapid change in the organizational paradigm of the economic system, as well as in health care in Ukraine. In this paper we aim to highlight the key features of the ongoing health reform in Ukraine, identify basic challenges for it, and assess rationality and feasibility of the reform. We found that the projected scope and schedule of changes in the Ukrainian health system give promising prognosis regarding its final effect.
The final success of health reform in Ukraine is dependent on a number of factors, including the financial foundation arising of economic stability of the country, balance assurance between public and private spending for health and ability to eliminate the long-lasting practices, particularly when they are connected with activities of lobbying groups occupying particular positions in the health system. A consequence of actions taken by the political decision-makers in the longer perspective are also to highly determine the reform's chances for success.
乌克兰是苏联解体后形成的最大国家之一,被广泛认为是一个错失机会的国家。由于腐败的肆虐,它显示出无法实现现代化并走上可持续增长的经济道路。同样,在后苏联时期,医疗保健系统也没有进行更深层次的改革努力,使该系统陷入了苏联时代遗留的无效解决方案的束缚之中。
最近的地缘政治和经济危机似乎有利于引入激进的解决方案,这可能导致经济体系的组织范式以及乌克兰医疗保健发生快速变化。本文旨在强调乌克兰正在进行的医疗改革的关键特征,确定其面临的基本挑战,并评估改革的合理性和可行性。我们发现,乌克兰卫生系统预计的变革范围和时间表对其最终效果给出了有希望的预测。
乌克兰医疗改革的最终成功取决于多个因素,包括国家经济稳定所带来的财政基础、公共和私人卫生支出之间的平衡以及消除长期存在的做法的能力,特别是当这些做法与在卫生系统中占据特定职位的游说团体的活动有关时。政治决策者从长远角度采取的行动后果也将极大地决定改革成功的机会。