BUDGETING IN HEALTHCARE INSTITUTIONS IN THE CONDITIONS OF MEDICAL REFORM IN UKRAINE

Abstract

Purpose: to analyze the features of budgeting in healthcare institutions of Ukraine in the context of healthcare reform and to identify ways to increase the efficiency of financial planning taking into account new financing mechanisms. Materials and Methods. The study used the regulatory framework of Ukraine in the field of healthcare and finance (laws, resolutions of the Cabinet of Ministers of Ukraine, orders of the Ministry of Health, regulatory documents of the National Health Service of Ukraine); statistical data of the Ministry of Health of Ukraine, the National Health Service of Ukraine and the State Statistics Service; methods of analysis and synthesis – to identify the main trends in the financing of healthcare institutions; comparative method – to assess changes in budgeting before and after the implementation of healthcare reform; systemic approach – for a comprehensive consideration of the financial aspects of the functioning of healthcare institutions. Results. An analysis of the activities of the KNP «Central City Hospital» of the Rivne City Council in 2022–2024 showed the stability and predictability of the institution's financial support, which is an important factor in the successful implementation of healthcare reform at the local level. All three years saw an overachievement of the budget targets: in 2022, actual revenues exceeded the planned ones by UAH 4.8 thousand, in 2023 by UAH 7.0 thousand, and in 2024 by UAH 16.5 thousand. This indicates not only the effectiveness of financial planning, but also the availability of additional sources of financing, including funds from the provision of paid medical services, rent for the use of premises, other operating income and contracts with the National Health Service under the medical guarantee program. A detailed analysis of revenues by structural units showed that the largest financial contribution was formed by departments that provide highly specialized care: a polyclinic, a regional neurosurgical department, a traumatology department, a neurological department with a stroke unit, as well as a department of transplantation and surgical pathology. Conclusions. Thus, the KNP «CML» of the RMR demonstrates not only medical efficiency, but also financial stability, which creates a basis for further strategic development and increased competitiveness in the context of the transformation of the healthcare system of Ukraine.