General approaches to the creation of an inter-integral rehabilitation system in Ukraine

Abstract

Purpose: The article is devoted to the analysis and development of general approaches to the creation of a structural model of an integrated rehabilitation system in Ukraine in the current conditions of growing population needs.Materials and methods. The research was based on data from open sources: regulatory acts of Ukrainian legislation, reports of the statistical system of the Ministry of Health of Ukraine, and data from the State Statistics Service of Ukraine for 2020–2025; scientific publications on rehabilitation, its organization, and effectiveness. To achieve the research objectives, content analysis of regulatory and legal acts, causal analysis of reform processes, a structural-genetic approach to building a rehabilitation system model, and basic descriptive statistical analysis of official data were used, as well as multidimensional regression, factor, and geoinformation analysis.Results. The analysis of legislative initiatives and international experience indicates a high potential for the creation of an effective integrated rehabilitation system in Ukraine. The introduction of European standards can significantly improve the quality of rehabilitation services and facilitate the implementation of rehabilitation intervention packages, tools for assessing national rehabilitation personnel, and the integration of rehabilitation into health financing mechanisms. However, the lack of specific mechanisms for implementing integration approaches creates barriers to the practical application of legislative initiatives. The results of the study revealed regional disparities in the distribution of rehabilitation resources in Ukraine, which is a consequence of the fragmentation of the existing infrastructure.Despite the positive trend in the growth of the number of rehabilitation centers, it was found that remote areas lag significantly behind in providing access to quality rehabilitation services. An analysis of regulatory and legal acts confirmed that the legislative framework for the rehabilitation system partially integrates European standards, but remains insufficiently specific in terms of algorithms for interaction between system actors. The lack of coordination mechanisms between central and regional structures complicates the implementation of integration approaches. The use of factor analysis methods to model the interaction between actors in the rehabilitation system is a promising direction for improving the effectiveness of policy implementation at the local level. An assessment of statistical data revealed an overall improvement in the infrastructure capacity of the rehabilitation system, but staff shortages, especially in rural areas, remain a critical problem. Multivariate regression analysis was used to gain a deeper understanding of the impact of regional characteristics on staffing levels. This made it possible to quantitatively assess the relationships between funding indicators, the level of training of specialists, and the quality of rehabilitation services in different regions. The proposed structural model of interaction between actors in the integrated rehabilitation system in Ukraine is theoretically sound and has significant potential for practical application. At the same time, its successful implementation will require strengthening multidisciplinary coordination between medical, social, educational, and community structures with the active use of digital technologies. Methodologically sound application of system modeling allows for the assessment of various scenarios for the development of the rehabilitation system and the prediction of its effectiveness in the context of long-term national strategies.Conclusions. Thus, this work is an important contribution to the understanding of current trends in the reform of the rehabilitation system in Ukraine with regard to improving the quality of services for all segments of the population.