THE STATE OF FINANCIAL PROTECTION OF THE POPULATION OF UKRAINE WHEN RECEIVING PRIMARY HEALTH CARE

Abstract

Purpose: assessment of the state of financial protection of the population of Ukraine when receiving primary health care.

Materials and Methods. Data from the WHO Global Health Expenditure Database in general and primary health care (PHC) for 2020 were used, as well as materials of the National Health Service of Ukraine for 2018–2023. The research was conducted using bibliosemantic, historical methods, and benchmarking.

Results. Spending on primary health care as a % of gross domestic product in Ukraine in 2020 was 2.1 %, and the share of total healthcare spending on primary care was 38 %, which corresponded to the range of costs for countries with incomes below the average and differed little from the indicators of Ukraine's neighboring countries. The real costs of primary care per capita amounted to 104 US dollars and 307 US dollars in terms of purchasing power parity, which is 31–26.7 % lower compared to Moldova – a country that, like Ukraine, belongs to the group with below-average incomes and is 3.8–2.6 times lower than in neighboring countries with Ukraine, countries with high levels of income. The per capita (capitation rate) for primary care within the framework of the state guarantee program for the period 2018–2023 increased by 30 % in dollar terms, which led to the limitation of official payments by patients for primary care and the expansion of the range of guaranteed services. At the same time, the ratio of public and private spending on primary care in Ukraine was 26 % to 74 % and was one of the worst indicators in the European region.

Conclusions. Research has established that in Ukraine in recent years, certain successes have been achieved in improving the financial protection of patients in the primary care system by the reform of state funding based on the per capita principle, a certain increase in budgetary funding of primary care and the expansion of the package of guaranteed services

At the same time, the level of financial security in this area remains extremely low, which is due to chronic underfunding within the framework of the medical guarantee program of the "Primary medical care" package, and significant out-of-pocket costs for drugs and diagnostic tests.