Hromtseva D.

Universit edu Maine (France)

ON THE FINANCING OF HEALTH CARE IN UKRAINE

Ukraine is a country with an impressive space for production activities due to rich natural resources, its sufficient human potential and the potential capacity of the domestic market. One of the markets, where many new technologies have been being introduced, is the market for services.

Nowadays one of the priority tasks, which the government is facing, is to optimize budget expenditures including those on health care. Many countries of the world, mostly highly developed ones, achieve sharp reduction in expenditures on hospital services through the development of a network of medical establishments for a short-term stay.

One of the important and real ways to reduce resource expenditures on specialized in-patient health care is the widespread use of day-time hospitals and home-stay hospitals at primary level of health care as the organizational technologies of substituting the in-patient medical care. A special role in the organization of these forms of treatment is given to the introduction of general practice / family medicine and providing assistance by GPs (family) doctors.

In order to identify the main directions of improving the management of the health care system in Ukraine, we can consider and analyze one of the most effective and successful health care system – the health care system of France. It has been recognized as the best health care system according to WHO for several years.

France is a country with traditionally high expenditures on health care; it occupies the third place in the world (after the USA and Switzerland) by the volume of services. According to the Organization for Economic Cooperation and Development in 2013 France ranked as the fourth, as it can be seen in Table 1.

The health care system of France allows using both traditional therapeutic services and the latest scientific achievements to all the French. To overcome the demographic crisis, Ukraine needs to increase the effectiveness of its health care system by improving the financing of the industry, which is possible through the introduction of the insurance medicine, reduction of the role of public funds in the financing of health care and the creation technologies of substituting the in-patient medical care.

Table 1.Health care expenditures and financing

Country	2005	2006	2007	2008	2009	2010	2011	2012	2013	2014
Austria	9,6	9,5	9,5	9,6	10,1	10,1	9,9	10,1	10,1	10,2
Belgium	9,0	8,9	9,0	9,4	10,1	9,9	10,1	10,2	10,2	10,3
Canada	9,1	9,3	9,4	9,5	10,6	10,6	10,3	10,2	10,2	10,0
Denmark	9,1	9,2	9,3	9,5	10,7	10,4	10,2	10,4	10,4	10,5
France	10,2	10,1	10,0	10,2	10,9	10,8	10,7	10,8	10,9	11
Germany	10,3	10,1	10,0	10,2	11,1	11,0	10,7	10,8	11,0	11,1
Japan	8,1	8,1	8,2	8,5	9,4	9,5	10,0	10,1	10,2	10,2
Netherlands	9,5	9,4	9,4	9,6	10,3	10,4	10,5	11,0	11,1	11,1
Sweden	8,3	8,2	8,1	8,3	8,9	8,5	10,6	10,8	11,0	11,0
Switzerland	10,3	9,8	9,6	9,8	10,4	10,5	10,6	11,0	11,1	11,1
USA	14,6	14,7	14,9	15,3	16,4	16,4	16,4	16,4	16,4	16,4

Estimated as a percentage of GDP

Day-time hospitalization provides multivalent, individual or intensive treatment. Surely, day-time hospital facilities have a more “like home” interior than the “like hospital” one. The home-stay hospitalization can be organized due to patient health condition, which requires special organization by the inter-profile medical teams.More often the technologies of substituting the in-patient medical care are used in cases of mental illness. Long-term care for the elderly and incapacitated people can be provided at home or in specially designated facilities [1].

The forms of substituting the in-patient medical care are regulated by the French legislation.An important role in providing assistance with medical care and hospitalization is given to psychological centers (CMP). Usually they are situated outside the hospitals and provide advice to all comers – with the receipt from a physician or byone’s own initiative. In addition, there are medical and psycho-pedagogical centers (SMRR) involved in the detection, diagnostics and treatment of mental and behavioral disorders for children and adolescents. They work in close cooperation with child protection and maternitycenters, schools, social and pedagogical, psychiatric services.

In addition, there are day-time care hospitals for patients with chronic dermatoses. The complex of the given medical care measures includes therapies that can not be provided at home. Average treatment in that kind of day-time hospitalslasts from 1 day up to 3-4 weeks. The cost of treatment in day-time hospitals is three times less than at the24/7 in-patient hospitals [2].

So, if to take into consideration the experience of one of the best health care systems in the world, we can conclude that the introduction of technologies of substituting the in-patient medical care positively affects the health of the nation, as well as it leads to a significant reduction of expenditures on treatment of certain patient groups. As Ukraine is on the way to active development in the European direction, we could take advantage of the European experience in introduction of day-time in-patient hospitals to improve the management of the Ukrainian health care system in the future.

List of references:

1. Leclerc R. la France malade de son système de santé? [Electronic resource] / R. Leclerc. – Available online at:http://delitsdopinion.com/1analyses/la-france-malade-de-son-systeme-de-sante-259

2. Дейниховська К. А. Європейськіпринципи та методифункціонуваннясистемиохорониздоровя (на прикладіФранції та Іспанії)[Електронний ресурс]. − Режим доступу :http://kbuapa.kharkov.ua/e-book/db/2008-2/doc/5/04.pdf