Reforming health care in Ukraine

One of the pathways of reforming health care in terms of improving quality and accessibility to medical treatment is the engagement of people uniting under a sickness fund using the solidarity principle.

General principles of optimising the work of sickness funds in Ukraine:

1. Absence of financial ceiling to the expenses of pharmaceuticals in case of illness and absence of constraints towards the amount of treatments

2. Using standardised procedures for the medicinal treatment (using positive list of pharmaceuticals and clinical pathways)

3. Catchment area in which patients receive treatment needs to cover the whole territory of an Oblast (regional administrative unit)

4. Presence of a quality assurance system that manages the rational use of available resources

5. Direct purchase of pharmaceuticals from wholesale and pharmaceutical producers

6. The establishment of contractual relationships with health care providers

7. Providing of benefits in kind to the members of sickness fund through contracts with health care providers

8. Ongoing improvement of quality in the service delivery of health care

Recommendations by our association to

the level of the Ministry of Health Ukraine:

  • To prepare and submit to the Verkhovna Rada the draft law “on sickness funds” according to the legislative procedures.
  • To include in the official list of health care professions a category for “physician-experts”.
  • To implement a positive list as basis for purchasing and prescribing pharmaceuticals

the level of executive administration of public health care:

  • To implement the particular technical recommendations related to sickness funds.
  • To introduce programmes for human capacity development of health care professionals working at the sickness funds.
  • To use the available figures on expenditures of sickness funds to forecast the financial demand of pharmaceuticals for state health care facilities.
  • To implement the quality assurance programme in the diagnostic and treatment processes, used by the charitable organisation „sickness fund of Zhytomyr region”.

the level of higher medical educational establishments (accreditation level I-IV):

  • To introduce in physician study programmes modules and lectures of capacity development on principles of building and executing sickness funds.
  • To include in the study activities scientific research projects that deal with the investigation of organisational models for sickness funds, development and implementation of clinical protocols for health care treatment delivery.