Providing the population of Transcarpathian Region with dental care under the program of medical guarantees

Abstract

Purpose: to study the level of provision of dental care to the adult population of the Transcarpathian region under the Medical Guarantee Program.Materials and methods. Object of study: provision of free dental care in health care institutions of Transcarpathian region.Research materials: electronic records of the National Health Service of Ukraine for the period 2021–2024 in the context of health care institutions of the Transcarpathian region. Research methods: bibliosemantic, medico-statistical, of structural-and-logical analysis.Data processing was carried out with the use of generally accepted methods of medical statistics.Results. During the period of the study, guaranteed dental care was provided to the population of the Transcarpathian region in health care institutions of the general network and two specialized dental clinics. During the study period, the number of health care institutions in which dental care was provided decreased by five and in 2024 included 17 institutions. In the process of reforming the health care system of the region, the «Transcarpathian Regional Clinical Dental Polyclinic» of the Transcarpathian Regional Council was liquidated. At present, one specialized health care institution in the region – the Communal Non-Commercial Enterprise «Svalyava Dental Center» of the Svalyava City Council of the Transcarpathian region is functioning. For 2024, 3 health care institutions (Communal Non-Commercial Enterprise «Uglya Hospital» of the Uglya Village Council of the Tyachiv District of the Transcarpathian Region, Communal Non-Commercial Enterprise «Teresva Hospital» of the Teresva Village Council of the Tyachiv District of the Transcarpathian Region, Communal Non-Commercial Enterprise «Tereblya Hospital» of the Bushtyn Village Council of the Tyachiv District of the Transcarpathian Region) have concluded an agreement with the National Health Service of Ukraine on the provision of free dental care to the population by the state program of medical guarantees, but it is not provided. Despite the presence of an extensive network of specialized institutions of dental medical care of private ownership in the region, none of them has concluded an agreement with the National Health Service of Ukraine for the provision of medical care to the population within the framework of the state Program of Medical Guarantees over the years of the study. The number of the population of the region who received dental care under the program of state guarantors by years was: 2021 – 56402 persons, 2022 – 63148 persons, 2023 – 61467 persons, 2024 – 52578 persons. There exists a tendency to reduce the volume of dental care under the program of state guarantees. Of the total number of people who received dental care, up to 34.7% were children. Some health care institutions provide dental services to less than 400 patients per year, which, according to evidence-based management, does not ensure their quality. In the structure of the reasons for the population's request for dental care, up to 3.0% were preventive appeals, the rest of the appeals were for therapeutic purposes. At the same time, not all health care institutions that have concluded contracts with the NHSU provide preventive dental services. The data obtained indicate that in the Transcarpathian region, the WHO principles adopted for implementation in the health care system of Ukraine, which are defined by the «Global Strategy to Combat Oral Diseases», are not implemented.Conclusions. The analysis indicates that the organization of the provision of dental care to the population under the program of State Guarantees in the Transcarpathian region is not a priority and requires managerial decision-making in order to provide the population with geographically available dental care.