Ukrainian health care system and its chances for successful transition from Soviet legacies
Ukrainian health care system and its chances for successful transition from Soviet legacies
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DOI：
10.1186/s12992-018-0439-5
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发表时间：
2018-11-23
影响因子：
10.8
通讯作者：
Semigina, Tetyana
中科院分区：
文献类型：
--
作者：
Romaniuk, Piotr;Semigina, Tetyana
背景
乌克兰是在苏联解体后的废墟上形成的最大的国家之一，被广泛认为是一个错失机遇的国家。它因腐败而遭受重创，表现出无力进行现代化并走上可持续增长的经济道路。同样，在整个后苏联时期，医疗保健系统也没有进行更深入的改革努力，使得该系统仍受苏联时期低效解决方案的束缚。
正文
近期的地缘政治和经济危机似乎有利于引入激进的解决方案，这可能会导致乌克兰经济体系以及医疗保健的组织范式迅速改变。在本文中，我们旨在强调乌克兰正在进行的医疗改革的关键特征，确定其面临的基本挑战，并评估改革的合理性和可行性。我们发现，乌克兰医疗系统变革的预期范围和时间表对其最终效果给出了有希望的预测。
结论
乌克兰医疗改革的最终成功取决于多个因素，包括国家经济稳定所产生的财政基础、公共和私人医疗支出之间的平衡保障以及消除长期存在的做法的能力，特别是当这些做法与在医疗系统中占据特定位置的游说团体的活动有关时。从更长远的角度来看，政治决策者所采取行动的结果也将在很大程度上决定改革成功的机会。
BackgroundUkraine, one of the largest states formed on the rubble of the Soviet Union, is widely perceived as a country that has lost its opportunities. Being devastated by corruption, it shows incapable to modernize and enter the economic path of sustainable growth. Similarly in the health care system no deeper reform efforts have been taken in the entire post-soviet period, leaving the system in bonds of ineffective solutions taken out of the Soviet era.Main bodyThe recent geopolitical and economic crisis seem to favor the introduction of radical solutions that might lead to a rapid change in the organizational paradigm of the economic system, as well as in health care in Ukraine. In this paper we aim to highlight the key features of the ongoing health reform in Ukraine, identify basic challenges for it, and assess rationality and feasibility of the reform. We found that the projected scope and schedule of changes in the Ukrainian health system give promising prognosis regarding its final effect.ConclusionsThe final success of health reform in Ukraine is dependent on a number of factors, including the financial foundation arising of economic stability of the country, balance assurance between public and private spending for health and ability to eliminate the long-lasting practices, particularly when they are connected with activities of lobbying groups occupying particular positions in the health system. A consequence of actions taken by the political decision-makers in the longer perspective are also to highly determine the reform's chances for success.