Analysis of the physicians assessment of the current implementation of health care reform in Ukraine

Abstract

Aim. To determine the level of interest of doctors in the implementation of health care reform; to evaluate the impact of introduction of "family medicine" on provision of medical care to the population; to identify the level of support for the reform of the primary care unit by district doctors; to explore the need to implement a guaranteed package of medical services and health insurance; to determine the attitude of doctors to changes in medical education. Material and Methods. For this purpose, a questionnaire was developed and 84 physicians of different specialties and with different work experience were interviewed at the Faculty of Postgraduate Education of the Danylo Halytsky National Medical University in Lviv, from November 2017 to January 2018. Results and Discussion. It was found that the majority of doctors (85.7%) are interested in reforming the health care system; on the other hand, they do not always understand the essence of the proposed reforms, and therefore do not support changes (only 51.2% of respondents approve of the principle of "Money per patient"; 48,8% support the formation of drug prices; 60.6% positively assess changes in the primary level). Despite the considerable time and money spent on reforming the primary care unit since 2005, according to the conducted survey, the implementation of "family medicine" deteriorated medical aid to the children's population (61.9%) and failed to improve the level of care for the adult population (65.5%). The level of support for primary care reform by district doctors is high. 60.6% of doctors in this category have positive expectations and support the proposed changes. However, 32.1% of doctors have negative expectations and predict complications of the work of the district service. Nineteen per cent of doctors support the feasibility of using American tests to determine the level of training of doctors in the licensed exam, while the majority of respondents, 81%, does not support the initiative, believing either in prior introduction of international training standards (52.4%) or in training Ukrainian graduates according to to Ukrainian reality (28.6%). The abolition of distribution for graduates of medical universities is supported by 79.8%, and 14.3% believe that the distribution should be preserved. Conclusions. Despite a large number of publications on health care reform, virtually no surveys on healthcare system changes are conducted among physicians. At the same time, the level of interest in the reform in this category is high. Instead, the lack of information leads to lack of understanding by doctors of the peculiarities of the implementation and the content of the reforms, and subsequently to the rejection of its individual components.

Keywords

• health care system, reforms, opinion of doctors