ANALYSIS OF THE VIEWS OF HEALTH CARE ORGANIZERS ON THE PROSPECTS FOR SECONDARY MEDICAL CARE REFORMING IN THE PILOT REGIONS OF UKRAINE

Abstract

The purpose of our study was to study the opinion of healthcare professional among health care managers regarding the existing problems in the industry, the feasibility of further reforming secondary inpatient care
Materials and methods. The use of a systematic approach, as the basic methodology of the study, required studying the sociological aspect of the organization of secondary inpatient care as a component of the health care system in Ukraine. The sociologic study was conducted among the professionals to consider their opinions on the problems of the industry and the expediency of further inpatient care reformation, including rehabilitation health care, namely, 172 heads of health care institutions in Ivano-Frankivsk Region, 129 in Cherkasy Region and 125 in Chernihiv Region took part in the conducted anonymous questionnaire, this exceeded the representative number of the first managers of health care institutions and their deputies in corresponding Region (not less than 167, 123 and 121 respondents).
Results and discussion. In the process of analyzing the results of a sociological survey, it was found that most respondents expressed just partial satisfaction of their need for inpatient care, in particular, due to the low level of access to treatment for various reasons.
When asked about the expediency of further reducing hospital bed capacity in the Region, a large number of respondents in each sample answered positively, choosing different ways to increase the efficiency of using hospital beds: 47.3±3.9% of the respondents in Ivano-Frankivsk Region, 49.6%±4.4% in Cherkasy Region, 54.5±4.5% in Chernihiv Region believed that during the reduction the real needs of the population for inpatient medical care should be taken into account, and 26.9±3.4%, 41.7±4.4% and 32.5±4.2%, in relevant Regions, indicated that it is necessary to reduce beds that are not used at full capacity. The respondents’ opinions were divided into two halves, namely, their answers to the questions about the appropriateness of opening interterritorial hospitals for intensive care: 50.3±3.9% of respondents in Ivano-Frankivsk Region, 44.1±4.4% in Cherkasy Region and 44.7±4, 5% Chernihiv Region responded positively, and 49.7±3.9%, 55.9±4,4% and 53.7±4.5%, in relevant Regions, considered this decision inappropriate. Opponents of the opening such hospitals mentioned possible decrease in the geographical accessibility to inpatient rehabilitation care for residents of the administrative territories where such a hospital would be absent.
Conclusions. It was found that the needs of the population for inpatient medical care are not fully met, the latter being associated with both medical (lack of necessary types of medical care) and non-medical reasons. The prospects for reforming the rehabilitation medical care are aimed at the need for comprehensive changes in the organization of secondary, outpatient, as well as primary care. According to the results of the survey, it was confirmed that, there is a problem of rational use of the existing bed capacity despite the organization of the hospital network. Possible ways of improving hospital bed capacity, in the opinion of the respondents, namely 47.3±3.9% in Ivano-Frankivsk Region, 49.6±4.4% in Cherkasy Region and 54.5±4.5% in Chernihiv Region, are to reduce the number of beds in accordance with needs of the population, and 26.9±3.4%, 41.7±4.4% and 32.5±4.2% of respondents in relevant Regions mentioned reduction of beds that are not used at full capacity.
The results of the sociological survey conducted among the heads of health care institutions made it possible to identify the problempoints in the organization of inpatient medical care in the regions as well as priority tasks and directions of its reforming.