乌克兰医疗保健系统的理论和方法基础

Іhor Shyshka, Olga Mashchenko, Viktoriia Tomareva
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引用次数: 0

摘要

本文旨在通过定义乌克兰医疗系统的目标和功能、研究其主要结构要素和 2010-2019 年间的绩效指标,以及确定将当前医疗系统归类为特定医疗系统模式的主要分类特征,为乌克兰医疗系统的运行建立理论和方法论基础。研究方法。研究基于对医疗系统功能概念的理论研究。结果。文章将 "医疗系统 "定义为由国家、市政和私人组织组成的分层结构,这些组织作为管理的主体和客体相互作用。这些组织实施医疗、财务、组织、社会经济和其他措施,通过恢复生理和心理功能来维持人类的最佳表现和社会活动。医疗保健系统的主要目标得到了强调。确定医疗保健系统的职能从属于其主要目标,并反映其在与外部环境互动时的有序、规范和有组织的行为。强调医疗保健系统的功能是其组成要素运作的综合结果。实际意义。对 2010-2019 年期间医疗保健系统主要绩效指标的分析和特征描述表明,该部门现有的基础设施仍然相当繁琐,其特点是以专科和住院医疗保健为主,门诊设施的潜力未得到合理利用。在所有权、融资方式、国家在行业管理中的作用以及对医疗专业人员和消费者的激励等关键标准方面,国家医疗保健系统仍有塞马什科模式的痕迹,不符合使用昂贵医疗技术的现代要求,也无法提供高质量的医疗保健服务。价值/独特性。现已确定,改革国家医疗系统的主要手段是成立医院信托基金,这将保证医疗服务的改善,并大幅降低乌克兰医疗基础设施的维护费用。此外,人们还认识到,建立一个成功的医疗设施网络的关键技术应该是国家医疗系统各个层面的战略规划。
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THEORETICAL AND METHODOLOGICAL FOUNDATIONS OF THE HEALTHCARE SYSTEM OF UKRAINE
The aim of this article is to establish the theoretical and methodological basis for the operation of Ukraine's healthcare system through the definition of its objectives and functions, examination of its primary structural elements and performance indicators between 2010-2019, and identification of the key classification features that categorise the present healthcare system as belonging to a specific model of medical systems. Methodology. The study is based on theoretical research on the concepts of healthcare system functioning. Results. The article defines the "healthcare system" as a hierarchical formation of state, municipal, and private organizations that interact as subjects and objects of management. These organizations implement medical, financial, organizational, socio-economic, and other measures to maintain optimal human performance and social activity by restoring physiological and psychological functions. The main objectives of the healthcare system are highlighted. It is determined that the functions of the healthcare system are subordinated to its main goals and reflect its orderly, regular and organised behaviour in interaction with the external environment. It is emphasised that the functions of the healthcare system are an integrated result of the functioning of its constituent elements. Practical implications. The analysis and characterisation of the key performance indicators of the healthcare system for the period 2010-2019 showed that the existing infrastructure of the sector is still rather cumbersome, characterised by the dominance of specialised and inpatient medical care and irrational use of the potential of outpatient facilities. In terms of key criteria, such as ownership, financing methods, the role of the state in managing the sector, and incentives for healthcare professionals and consumers, the national healthcare system still has signs of the Semashko model, which does not meet modern requirements for the use of expensive medical technologies and is unable to provide high quality healthcare services. Value/originality. It is established that the primary means to reform the national healthcare system is through the formation of hospital trusts, which will guarantee improved medical services and significantly decrease the expense of maintaining medical infrastructure in Ukraine. Additionally, it is acknowledged that the key technology for forging a successful network of medical facilities should be strategical planning at all levels of the country's healthcare system.
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