Gromtseva Dariya

Universite du Maine



In recent years the level of interest to the management of health care institutions significantly increased. Integration is one of the most important factors that affect the country, its systems and, of course, the healthcare system. They caused the increase in scientific interest to the field of health. Today Health economics represents a valuable tool for improving the information base upon which healthcare decisions are made [1].

Healthcare institutions represent one of the elements of country’s economic development in general. They provide economic stability of population, as they offer the greatest number of new budget-funded jobs in the country, they also have a direct impact on population productivity and labour productivity.

Modern healthcare systems, functioning and developing in a liberal social order, feel a strong influence from other various systems responsible for adequate standard of living in the civilized markets. At the same time, these processes of mutual effect are bilateral: the healthcare system in the world is increasingly affecting the market and political structures.

Market for healthcare services is a combination of medical technologies, medical equipment, organizational methods of medical activity, pharmacological means, medical exposure and prevention.

In order to improve the healthcare system in Ukraine it is necessary to implement reforms of the healthcare system. This implementation aims at improving the management of medical institutions and reorganization of the health system as a whole. Highly qualified managers, who understand the need for change in this system, should be engaged in governance.

The following models of healthcare institutions management can be distinguished:

1. Organizational – principles of units forming, delegation of powers and giving responsibility are represented.

2. Coordination – aimed at improving the initiation and increasing of motivation of each employee and the whole team.

3. Operational – management of current events; a set of measures that affect the deviation of production tasks.

There are local and central healthcare authorities traditionally. The Ministry of Healthcare refers to the central authorities. This body is responsible for the state and development of medical care. Local authorities include regional, district, local healthcare authorities. They function for the development of medical institutions, their rational allocation, organization of primary health care and others. Health authorities direct and coordinate the work of medical institutions.

In Ukraine the medical aid is distributed into 3 levels: primary care – the clinics, which provide services of medical practitioners and medical specialists; Secondary care – hospitals of city, district and regional levels; tertiary care – highly specialized hospitals or standard hospitals, which provide highly specialized services [2].

The system of medical care was changed during the reform and now it is distributed into 3 main levels. Primary health medical care – medical care provided by family physicians in majority of clinics, where consultations, simple diagnosis are provided, preventive measures are organized, patients receive a referral for providing secondary and tertiary care. At the primary level centres of primary health care are established, which are actually legal entities that include district departments of clinics and hospitals, ambulatory general practice / family medicine, midwifery stations etc.

 More specialized medical care is provided by doctors at the secondary level of heath care. This is a secondary (medical and sanitary) aid, which includes counselling, prevention, diagnosis, and treatment at the highest level. Hospital District is a functional association of several administrative units, which provide the population with secondary (specialized) healthcare of varying intensity, complex of medical institutions to meet the requirements of the population for health care and demand forecasts for medical services, as well as respecting the principles of geographical and financial availability [2].

Highly specialized, high-tech medical care is provided in tertiary regional hospitals and clinical Research Institutes.

So basing on the above, some features of health care institutions management can be highlighted: 1. Staff should be focused primarily on providing high-quality medical care and consultations for the patients; 2. The central authorities should provide Centres for Primary Medical and Sanitary care, ambulatories and paramedic-midwife stations with necessary funding to ensure that people are provided with all the necessary medicines and others; 3. Management should be directed to preventive measures, promotion of healthy lifestyles and upbringing a sense of responsibility for their health among the population; 4. It is necessary to introduce new medical services that are aimed at improving medical care.

Reforms in the medical field were necessary to improve the health standards for population and increasing the status of a doctor among population. Regulating and control functions of the healthcare system that are essential in expanding autonomy management of health institutions were improved. In the future, the industry must work on standards and guidelines that are based on the availability and quality of health care, the most complete protection of rights of its key participants – the patients and medical staff.

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