Ukraine: Health system review.

摘要: The HiT profiles are country-based reports that provide a detailed description of health system and policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing delivery services role main actors systems; describe institutional framework, process, content implementation care policies; highlight challenges areas require more in-depth analysis. Ukrainian has preserved fundamental features Soviet Semashko against background other changes, which developed on market economic principles. transition from centralized its extreme decentralization is difference comparison with classic model. Health facilities now functionally subordinate Ministry Health, but managerially financially answerable regional local self-government, constrained fragmented financing. expenditure Ukraine low by standards not increased significantly as proportion gross domestic product (GDP) since mid 1990s; cannot match constitutional guarantees access unlimited care. Although prepaid schemes such sickness funds growing importance, out-of-pocket payments account for 37.4% total expenditure. core therefore remain ineffective protection population risk catastrophic costs structural inefficiency system, caused inefficient weaknesses highlighted increasing rates avoidable mortality. Recent political impasse complicated reforms policy-makers face significant overcoming popular distrust fatigue necessary yet unimplemented reforms.