Державне регулювання ринку медичних послуг в Україні

Abstract

У дослідженні розглянуто проблему наукового обґрунтування теоретико-методологічних засад та розроблення практичних рекомендацій щодо вдосконалення механізмів державного регулювання ринку медичних послуг в Україні. Здійснено системний аналіз наукових напрацювань, сформовано понятійно-категоріальний апарат дослідження, зокрема визначено поняття: «ринок медичних послуг» та «державне регулювання ринку медичних послуг». Систематизовано законодавство у сфері охорони здоров’я, проаналізовано трансформації ринку медичних послуг у сучасних умовах та ефективності його регулювання. Обґрунтовано теоретико-методологічні засади комплексного механізму державного регулювання ринку медичних послуг. Розроблено проєкт Концепції державного регулювання ринку медичних послуг. Здійснено сегментацію ринку медичних послуг на основі взаємодії його суб’єктів. Розроблено, апробовано та запроваджено оригінальний інструмент організації медичного обслуговування, за якого медичні послуги надаються в єдиному територіальному просторі «медичного коворкінгу» різними суб’єктами підприємництва при координації та контролі неприбутковою організацією чи дорадчим органом, членами якого є всі учасники коворкінгу.

The thesis research reviews a problem of scientific substantiation of theoretical and methodological principles and the development of practical recommendations for improving the mechanisms of state regulation of the medical services market in Ukraine. The first group of problems in question is linked to systematizing and developing the theoretical grounds for governmental regulation of activities of the healthcare service providers. Based on the studies of theoretical and methodological grounds and hands-on experience of developed countries, the author analyzes national healthcare models and specified features of the most economical and rational model when providing the patients with affordable and quality services. The second group of problems studied in the thesis concerns revealing the core of the mechanism of governmental regulation of the medical service market in the context of improving quality and efficiency of healthcare service provision. The interpretation suggested by the author defines the core of the mechanism of governmental regulation of the medical service market as a complex of regulating levers, principles, functions, goal, approaches and techniques aimed at ensuring an efficient and dynamic development of the medical service market. The work ascertains that among the basic levers regulating the medical service market, one can single out the following: price regulation, tax and duty benefits, setting the quality standards for medical service provision, norms and standards for pharmaceutical preparations and medical equipment used while providing the medical services, qualification level and requirements for the medical staff attestation procedure, applying low credit rates, offering attractive conditions of state property privatization and rent of state-owned properties, motivation, moral encouragement (moral and ethical norms of the society), and cooperation. The third group of problems reviewed in the thesis includes performance evaluation of the governmental regulation of the medical service market. A strategic interpretation of the research deliverables is offered, taking into account transformation of the medical service market and the pandemic’s influence on its development on the basis of SWOT-analysis. The researcher analyzes transformations in the medical service market in current conditions and efficacy of the governmental regulation. The thesis looks into how the mechanism of governmental regulation of medical service market is working as exampled by the changes that happened due to the COVID-19 pandemic and military invasion. It is ascertained that broadening the range and types of medical services on the basis of using computer and information technologies, updating the available hardware and software and acquiring new equipment, applying cloud technologies, and building a new information infrastructure will enhance information security of medical facilities to a large extent. It identifies the principles whose compliance will facilitate effective implementation of the mechanism of governmental regulation of medical service market. It is proved that the policy of reforming the medical service market is a flexible combination of market and regulatory aspects. There are arguments that introduction of medical insurance will not automatically enhance the healthcare performance but will require a number of public regulatory policy measures. It is confirmed that the government can affect the main variables in the medical service market (competition, prices for medical services, and investment) by adjusting the economic aspects, including methods of pricing. On the basis of a comprehensive approach to the state regulation of the medical services market, an original tool for the organization of medical services for the population was developed and implemented – under the terms of which medical services are provided in a single territorial space of «medical co-working» by various business entities with individual licenses for medical practice with mandatory medical coordination and quality control of service provision by a non-profit organization or an advisory comity, members of which are all co-working participants. Further development to improve understanding of directions for improvement of the legal framework is seen in the medical service market segmentation based on the interaction between operators as a result of the market mechanism action and governmental regulation tools that can be used.